Inappropriate hospital admission and length of inpatient stay: patients with long term neurological conditions

Walding, Christina L. (2010) Inappropriate hospital admission and length of inpatient stay: patients with long term neurological conditions. PhD thesis, University of Nottingham.

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Studies have shown that a proportion of patients admitted to hospital do not require the intensity of services they provide. Also, the admission of patients can be for an inappropriate duration.


Three studies were conducted. The first study was a record review to determine the appropriateness of patient admissions and inpatient stays. The second examined the wider causes of inappropriate admissions/inpatient stays as perceived by clinicians, and identified interventions to reduce such admissions/stays. Data were collected using focus groups. The final study explored barriers to service use from the perspectives of clinicians and patients. Data were collected from clinicians via an online questionnaire and from both clinicians and patients using semi structured in-depth interviews.


Of 119 patients, 32 were admitted inappropriately and 83 were admitted for an inappropriate duration. Risk factors for an inappropriate admission included living in the community compared to a nursing/residential home, and for an inappropriate length of stay included the number of presenting complaints, number of long term neurological conditions and whether the participant lived alone in their own home or with others. In the second study, the limited knowledge and a lack of health and social care resources in the community, were perceived as causes of inappropriate admission/lengths of stay. Interventions to prevent inappropriate admissions/lengths of stay included: sub-acute care facilities and patient held summaries of specialist consultations, among others. The final study found that the main barriers to use of services were out of hour's access and unfamiliarity of clinicians with local service provision.


The causes of inappropriate admissions/lengths of stay related, in main, to communication problems and accessibility of services. Interventions to improve transference of information and knowledge regarding long term condition management and service provision may be warranted.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Phillips, M.F.
Pinnington, L.L.
Keywords: Patient admission, Accessibility of health services, Communication in health services
Subjects: W Medicine and related subjects (NLM Classification) > WX Hospitals and other health facilities
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Community Health Sciences
Item ID: 28918
Depositing User: Blore, Mrs Kathryn
Date Deposited: 28 May 2015 07:34
Last Modified: 16 Sep 2016 01:36

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