Global hospital bed utilization crisis. a different approach

ABSTRACT

To test the effect of improved physician availability on hospital bed utilization. A prospective cohort study was conducted from 1 st January 2009 to 31 st March 2009 in the Division of Internal Medicine [DIM], King Abul-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