Logan Reid
Being admitted to a hospital can be a confusing and stressful experience, especially for those unfamiliar with the process. There are two main types of hospital admissions: emergent and elective. Emergent admissions occur when a patient is brought to the emergency department and subsequently admitted to the hospital, while elective admissions happen when a doctor schedules a reservation for a patient on a specific day. During the admission process, patients are typically asked about their preferences for resuscitation and given an identification bracelet to ensure they receive the correct treatments and medications.
| Characteristics | Values |
|---|---|
| Types of admission | Emergent/Emergency, Elective/Scheduled, Direct, Transfer |
| Who decides on hospital admission? | Personal doctor, Emergency department doctor, On-call physician, Hospitalist or specialist physician, Covering doctor |
| Patient type | Public, Private |
| Admission process | Patient checks in at the admissions office, Patient goes to the emergency department |
| Length of stay | Overnight, Several nights, Weeks, Months |
| Tests | Blood, Urine, Mental status testing |
| Procedures | IV line insertion, Feeding tube insertion, Intubation, Mechanical ventilation |
| Patient identification | Wristband with a unique, personal barcode |
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What You'll Learn
Elective vs. emergency admissions
Hospitals can be confusing and frightening for those unfamiliar with their inner workings. Generally, there are two types of hospital admissions: elective and emergency.
Elective Admissions
Elective admissions occur when a patient has a known medical condition or complaint that requires further treatment, workup, or surgery. In such cases, the patient's doctor requests a bed reservation for a specific day, and the patient checks in at the admissions office, bypassing the emergency department. Elective admissions constitute the majority of hospital admissions, but this percentage varies across hospitals.
Elective admissions are typically scheduled in advance, and a delay in treatment or diagnosis does not significantly impact the patient's health or safety. Patients may choose to wait for a more convenient time for their admission. They may also be instructed to come to the hospital several days in advance for lab work, X-rays, ECGs, or other pre-screening tests.
Emergency Admissions
Emergency or emergent admissions occur when a patient is seen in the emergency department and subsequently admitted to the hospital. These admissions usually result from trauma (injury) or an acute illness that cannot be managed on an outpatient basis. In some cases, patients are directly admitted to critical care, surgery, labor and delivery, or transferred from another hospital.
The decision to admit a patient to the hospital is typically made by medical staff, including the patient's personal doctor, an emergency department doctor, or a covering doctor during non-office hours. It is advisable for the emergency department doctor to consult with the patient's primary care physician to access important medical history information.
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Public vs. private hospitals
A hospital can be a public or private institution, depending on how it is governed. Public hospitals are funded and governed by the state, while private hospitals are funded and operated by private owners. There are several differences between public and private hospitals in terms of accessibility, affordability, quality of care, and patient experience.
Public hospitals are funded by the government and typically provide free or subsidised healthcare services to residents. They are more accessible, especially in rural areas, and often offer a wide range of medical services, including specialised departments and advanced medical technology. Public hospitals are usually the first choice for emergencies or acute health issues and tend to provide more care for uninsured patients. However, they may have longer wait times due to high demand and may offer limited privacy and comfort with shared rooms.
Private hospitals, on the other hand, tend to provide more personalised care with shorter wait times and a lower number of patients per doctor. Patients can often choose their doctor and may have more options for booking elective surgeries. Private hospitals can be more expensive, even with private health insurance, and may not be accessible to those who cannot pay or are uninsured. Private hospitals are known to provide extra services for patients who are paying more, such as private rooms.
The choice between public and private hospitals depends on individual preferences, financial considerations, and health needs. In some countries, such as Australia, individuals may opt for private health insurance to access both public and private healthcare options. It is important to review the costs, services, and quality of care associated with each system before making an informed decision.
In terms of efficiency, studies have shown varying results. Some studies indicate that private hospitals may have shorter wait times and accommodate booking requirements better. However, in Italy, for-profit private hospitals were found to be less efficient due to their limited number of funded admissions, and they exhibited more inappropriate admissions than public hospitals. In Greece, private hospitals were found to have less qualified nursing staff, possibly due to maximising profits and minimising expenses.
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Inpatient vs. outpatient services
Inpatient and outpatient services refer to a patient's location, type of care, and physician. Inpatient care involves an overnight stay in a hospital or other care setting, whereas outpatient care is when a patient can go home on the same day. Inpatient care is generally for more serious procedures and surgeries, and for patients who are critically ill. Outpatient care is for milder conditions and can be received in a doctor's office, clinic, or hospital outpatient department.
Inpatient Services
Inpatient services offer comprehensive care and support, addressing both the psychological and physical aspects of recovery. The intensive and immersive nature of inpatient care allows for deep therapeutic work and a focus on healing without external distractions. Patients have immediate access to medical staff around the clock, which is particularly important for those whose conditions are severe. Inpatient care also includes giving birth and surgeries that require at least one night in the hospital.
Inpatient care offers greater access to services in one facility, such as nurses, mental health professionals, and nutritionists. This type of care is particularly beneficial for those with mental health conditions, providing temporary around-the-clock care to help them get back to living safely on their own. However, inpatient care can be disruptive to daily life and responsibilities, and the controlled environment may feel restrictive to some. It also tends to be more expensive due to the intensive nature of the treatment and the need for full-time staff and facilities.
Outpatient Services
Outpatient services allow patients to maintain their independence and daily routines while receiving treatment. This type of care is suitable for those with milder conditions or those transitioning from inpatient treatment. Outpatient programs offer flexibility, allowing patients to attend therapy and treatment sessions during the day and return home at night. This helps patients integrate treatment into their lives without significant disruption and maintain their social connections, which can be beneficial for their mental health and recovery.
Outpatient care is generally less expensive than inpatient care and can range from standard outpatient therapy to more intensive options like partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs). However, outpatient care may not be suitable for those who need more support, as it offers less intensive care and supervision. The success of outpatient programs also depends on the patient's commitment to their treatment plan, and there is a potential for exposure to triggers in the home environment.
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Direct admit vs. transfer
Direct admission to a hospital means being admitted without first going through the hospital's emergency department (ED). Direct admission is usually initiated by a physician or a doctor who deems the patient ill enough during an office visit or a phone consultation to warrant direct admission. Direct admission offers several benefits, including improved communication and coordination between outpatient and hospital-based healthcare providers, greater patient and referring physician satisfaction, and reduced ED volumes and subsequent costs.
However, there are also risks associated with direct admission. These include potential delays in initial evaluation and management, inconsistent admission processes, and difficulties in determining the appropriateness of direct admission, which could adversely affect patient safety and quality of care. Additionally, direct admission may not always be the best option due to decreased bed availability, ED overcrowding, and hospitals operating at full capacity, resulting in increased waiting times even for directly admitted patients.
On the other hand, transfer admissions involve moving a patient from one hospital to another or from one department to another within the same hospital. Transfers can occur for various reasons, including insurance coverage, the availability of specialized care, or the patient's request. Transfers usually require an ambulance with trained personnel and may take some time, especially if the transfer is not deemed medically necessary.
The decision between direct admit and transfer depends on various factors, including the patient's condition, the availability of resources, and the potential risks and benefits of each option. While direct admission can provide a more streamlined approach and reduce ED congestion, it may also introduce complexities and potential delays that could impact patient safety. Therefore, it is essential to carefully evaluate each patient's needs and the capabilities of the admitting hospital to ensure the most appropriate course of action.
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Tests and procedures
If you are admitted electively, you will likely undergo prescreening tests before your admission, such as lab work, X-rays, and ECGs. During your hospital stay, you may undergo further tests, such as blood or urine tests, to check for problems. Staff members may ask questions about your eating habits, mood, vaccinations, and medications to determine if you are likely to develop problems while in the hospital or to need extra help after discharge.
An IV line is placed in almost every person admitted to the hospital. This is a flexible tube (catheter) inserted into a vein, usually in the crook of the arm, and is used to administer fluids, medications, and nutrients if needed. If you are staying in the hospital for an extended period, the IV line may need to be moved to avoid irritating the vein.
Upon admission, you will also be given an identification bracelet to wear at all times. This bracelet contains important information and is scanned by healthcare providers before administering medications, treatments, or tests to ensure proper care.
In some cases, more invasive procedures may be necessary, such as intubation (insertion of a breathing tube) or mechanical ventilation. Additionally, a feeding tube may be inserted into the stomach if nutrition cannot be administered orally.
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Frequently asked questions
There are two major types of hospital admissions: emergent and elective. Emergent admissions occur when a patient is seen in the emergency department and subsequently admitted to the hospital. Elective admissions occur when a doctor requests a bed reservation for a patient on a specific day, and the patient checks in at the admissions office. Elective admissions constitute the majority of hospital admissions.
The decision to admit a patient to a hospital is typically made by medical staff, including the patient's personal doctor, an emergency department doctor, or a covering doctor. Upon admission, patients are given an identification bracelet with a unique barcode to ensure proper care and medication administration. Various tests, such as blood or urine tests, may be conducted to check for problems, and an IV line is usually inserted. Patients are also asked about their living will and preferences for resuscitation.
The decision to admit a patient to a hospital depends on various factors, including the severity and urgency of their condition, the availability of treatment options, and the patient's medical history. In the case of elective admissions, the admission date and time may be chosen based on the convenience of both the patient and the doctor.
