Utilization of hospital in-patient services by the elderly.

A survey was made of the patterns of hospital admission for patients aged 65 or older in an urban practice under the management of a primary care team composed of a family physician, nurse, and medical social worker. Results showed that the elderly used a higher percentage of in-hospital facilities than did the younger age groups. However, admission rates were significantly lower than the local national rates, and involved relatively fewer cases of long-term illness. No patients over 65 were admitted for psychiatric care during the one-year period of observation. This was attributed to the provision of planned domiciliary programs for supervision of patients with long-term illness within a coordinated framework of primary medical care.

Hospital admission rates and the primary health team.

The use of hospital beds was studied for a period of one year in a practice under the care of a closely co-ordinated team composed of the family physician, the family nurse, and a medical social worker. Admission rates and mean duration of stay in hospital are analysed and discussed in relation to selected socio-demographic variables.The results showed that the study population used only half as many hospital beds when compared with national rates in Israel. We consider that this was achieved by the provision of planned co-ordinated comprehensive medical nursing and social services for patients suffering from long-term illness. Such a team is able to provide a high quality medical care and can significanlty reduce the use of in-patient hospital services.