An analysis of avoidable admissions to a neurology service

Inappropriate admissions to a hospital service generate unnecessary costs for our health care service. Most admissions to a hospital service come from the emergency department. The presence of a neurologist to attend hospital emergencies would be an important factor allowing admission criteria to be streamlined. To determine the number of avoidable admissions (AA) in a neurology service, and to define their characteristics. We conducted a prospective, descriptive study of the admissions that took place in the Neurology Service of the Hospital General Universitario de Elche (Alicante) over a period of three months. The neurologist determines whether admission is indicated or not. We collected demographic data concerning the patient, the admission diagnosis, neurological diagnosis, the reason for appropriateness and the reason for AA. A total of 250 admissions were attended; 65 were considered to be AA (26%). The most frequent diagnoses in the cases of AA were non-neurological (32.3%), clinical findings (15.4%), neuropathies (10.8%) and epilepsy (10.8%). The reasons leading to AA were non-neurological and transfer to another service (30.8%), follow-up by neurology outpatient department (NOD) (29.2%), NOD study (21.5%), non-neurological and discharge (16.9%) and not specified (1.5%). The mean length of stay in the case of AA was 4.3 days. The number of AA in our service is higher than that found in other studies. On-duty neurologists, streamlining outpatient diagnostic testing and the design of flexible schedules for outpatient care would reduce the amount of resources that are used, while at the same time increasing the quality of the health service.