David Oliver: Avoiding hospital admission - Are we really falling short

Abstract

Last week I wrote about the huge policy push to keep patients away from acute hospitals. The focus isn't surprising, with full hospitals, rising attendance and admission rates, exit block in patients who could technically leave,1 potential distress or risks to patients resulting from admission,2 3 and patients whose problems might have been prevented or dealt with upstream of hospital and closer to home.4 5 Here, I want to look at whether the evidence supports such efforts and how we might reframe the issue rather than reflexively labelling acute hospital activity as a problem.