Editorials

Emergency medical admissions: taking stock and planning for winter

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7119.1322 (Published 22 November 1997) Cite this as: BMJ 1997;315:1322

We need more logic and more honesty

  1. Oliver Blatchford, Research fellowa,
  2. Simon Capewell, Senior lecturera
  1. a Department of Public Health, University of Glasgow, Glasgow G12 8RZ

    Emergency medical admissions have risen by 50% since 1984 and now account for almost half of all NHS admissions.1 Through recurrent winter bed crises, disrupted elective admissions, growing waiting lists, and highly publicised interhospital transfers of seriously ill patients this continuing rise threatens the future of the NHS. Has anything changed since we last reviewed this problem?2

    We now understand better the epidemiology of emergency medical admissions. Winter peaks principally reflect respiratory and cardiovascular illness.3 Nevertheless, twofold variations exist between individual hospitals in both admission rates and increases in rates.4 Whereas the proportion of the total population using inpatient hospital services has remained almost constant,5 the number of patients readmitted four or more times in a five year period doubled between 1981 and 1994.

    Age and deprivation take their toll. People aged over 65 account for only 15% of the Scottish population but 37% of emergency admissions.1 This proportion may have …

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