Global hospital bed utilization crisis. A different approach

To test the effect of improved physician availability on hospital bed utilization. A prospective cohort study was conducted from 1st January 2009 to 31st March 2009 in the Division of Internal Medicine (DIM), King Abdul-Aziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia. Two clinical teaching...

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Bibliographic Details
Published inSaudi medical journal Vol. 31; no. 4; p. 434
Main Authors Waness, Abdelkarim, Akbar, Jalal U, Kharal, Mubashar, BinSalih, Salih, Harakati, Mohammed
Format Journal Article
LanguageEnglish
Published Saudi Arabia 01.04.2010
Subjects
After-Hours Care
Bed Occupancy
Crowding
Health Services Accessibility
Hospitals, Teaching
Humans
Outcome Assessment (Health Care)
Outsourced Services
Patient Admission
Patient Discharge
Patient Transfer
Physicians - supply & distribution
Prospective Studies
Saudi Arabia
Saudi Arabia
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Summary:To test the effect of improved physician availability on hospital bed utilization. A prospective cohort study was conducted from 1st January 2009 to 31st March 2009 in the Division of Internal Medicine (DIM), King Abdul-Aziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia. Two clinical teaching units (CTU) were compared head-to-head. Each CTU has 3 consultants. The CTU-control provides standard care, while the CTU-intervention was designed to provide better physician-consultant availability. Three outcomes were evaluated: patient outsourcing to another hospital, patient discharge during weekends, and overall admissions. Statistical analysis was carried out by electronic statistics calculator from the Center for Evidence-Based Medicine. Three hundred and thirty-four patients were evaluated for admission at the Emergency Room by both CTU's. One hundred and eighty-three patients were seen by the CTU-control, 6 patients were outsourced, and 177 were admitted. One hundred fifty-one patients were seen by the CTU-intervention: 39 of them were outsourced, and 112 were admitted. Forty-eight weekend patient discharges occurred during this period of time: 21 by CTU-control, and 27 by CTU-intervention. Analysis for odds ratio in both the rate of outsourcing, and weekend discharges, showed statistical significance in favor of the intervention group. The continuous availability of a physician-consultant for patient admission evaluation, outsourcing, or discharge during regular weekdays and weekends at DIM, KAMC proved to have a positive impact on bed utilization.
ISSN:0379-5284