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Hospital admissions from nursing homes: a qualitative study of GP decision making
- Authors:
- MCDERMOTT Clare, et al
- Journal article citation:
- British Journal of General Practice, 62(601), August 2012, pp.413-414.
- Publisher:
- Royal College of General Practitioners
Decisions regarding the hospitalisation of nursing home residents may present a difficult dilemma for GPs. There are pressures to admit very frail patients with illness even though such frailty may limit the possible health gains. This study investigated GPs views on factors influencing decisions on admitting frail nursing home residents to hospital. Interviews were held with 21 GPs from two counties in the South of England. Findings indicated that while clinical assessment, perceived benefits and risks of admission, and patients' and relatives' preferences were key factors in determining admissions, other important factors influencing decision making include medico-legal concerns, communications, capability of nursing homes and GP workload. These factors were also perceived by GPs as influencing the feasibility of keeping patients in the nursing home when this was clinically appropriate. Key areas suggested by GPs to improve practice were improving communication, training and support for nursing staff, and peer support for GPs.
Pressure gauge
- Author:
- GILBERT Helen
- Journal article citation:
- Care and Health Magazine, 11.5.04, 2004, pp.27-29.
- Publisher:
- Care and Health
Community hospitals are often seen as a safety valve for acute services, providing rehabilitation of patients who have had surgery or have been treated for serious illness in a district general hospital. Looks at how the new GP contract could jeopardise their existence.
How a rapid response can keep beds free
- Author:
- VALIOS Natalie
- Journal article citation:
- Community Care, 31.8.00, 2000, pp.28-29.
- Publisher:
- Reed Business Information
Reports on how a rapid response team in the north west of England has freed hospital beds and saved money by giving GPs a better option than referring patients to hospital.
A suitable case for treatment?
- Author:
- ZAATAR Ali
- Journal article citation:
- Health Service Journal, 19.4.01, 2001, pp.26-27.
- Publisher:
- Emap Healthcare
Reports on how fears that nursing home referrals to GPs and A&E wards were excessive and inappropriate were not borne out by a recent health study.
What is the relationship between general practitioners' community referrals, and hospital referrals to an old age psychiatric service
- Authors:
- BUTLER R., OYEWOLE D., PITT B.
- Journal article citation:
- Aging and Mental Health, 4(1), February 2000, pp.79-81.
- Publisher:
- Taylor and Francis
There is a large variation in the referral rates of general practitioners (GPs) to specialist services. There is also evidence that GPs under-refer patients with dementia and depression to old age psychiatric services. However, little is known about individual GP referral rates of these services. Patients may be referred to psychiatric services by GPs in the community (community referrals), or by physicians or surgeons, while the patients are receiving medical or surgical care in hospital (hospital referrals). One way of controlling for GP variables, such as practice size and the age profile of patients, may be to examine the relationship between hospital and community referrals for each GP. The study hypothesised that there would be a positive correlation between these types of referral.
The views of professionals and patients on compulsory removal from home to an institution (Section 47, National Assistance Act)
- Author:
- MAYBERRY John F.
- Journal article citation:
- Health and Social Care in the Community, 4(4), July 1996, pp.208-214.
- Publisher:
- Wiley
A total of 548 solicitors, nurses and community physicians, together with 67 elderly people who had been admitted to hospital with acute medical conditions in the previous 6 months were sent a questionnaire about Section 47, National Assistance Act legislation and its role at the end of the twentieth century. Forty-eight percent of professionally qualified people and 54% of patients returned the questionnaire. Community physicians, consultant geriatricians, social workers and solicitors were most aware of Section 47; but only 27% of nurses and 17% of elderly patients had heard of it. Patients were most enthusiastic for retention of these powers of removal and social workers least so.
The referral, investigation and diagnosis of presenile dementia: two services compared
- Authors:
- ALLEN Harry, BALDWIN Bob
- Journal article citation:
- International Journal of Geriatric Psychiatry, 10(3), March 1995, pp.185-190.
- Publisher:
- Wiley
The case notes of patients with presenile dementia presenting to a neurology service were compared with patients who had presented to a specialist old age psychiatric department (OAPD). Patients referred to the OAPD were inadequately investigated. Concludes that specialist old age psychiatric services in Britain have a role in the management of patients with presenile dementia but that diagnosis should be by neurologists.
Review of the special care (early hospital discharge) scheme
- Authors:
- EVANS E., FARNSWORTH Simon, HOWARD Mavis
- Publisher:
- Gloucestershire. Social Services Department
- Publication year:
- 1987
- Pagination:
- 64p., tables, diags.
- Place of publication:
- Gloucester
Report discussing the results of research into the current operation of this scheme, including cost-effectiveness, client profiles, consumer views, the perspectives of hospital social workers, hospital staff general practitioners and the opinions of home care staff.
Reducing unplanned hospital admissions and hospital bed days in the over 65 age group: results from an pilot study
- Authors:
- KEATING Patrick, et al
- Journal article citation:
- Journal of Integrated Care, 16(1), February 2008, pp.3-8.
- Publisher:
- Emerald
Against a background of an ageing population, rising emergency admissions and a policy direction moving towards providing care in the least intensive setting, this paper presents the results achieved in a 22-week pilot of undivided health and social care. The study replicated the Castlefields study which used and integrated model of care and using Unique Care principles. In the context of practice-based commissioning, where GP practices develop and commission services that represent the best model of care and use of resources for their patients, the potential for creating savings from this approach are discussed.
Home truths
- Author:
- BETTS Graeme
- Journal article citation:
- Health Service Journal, 9.1.02, 2002, pp.26-27.
- Publisher:
- Emap Healthcare
Argues that cross-charging will not improve care for older people, but a specialist workforce in the community might.