The aim of the study was to describe the pattern of admissions to a medical department and to analyse how far acute admissions can be replaced by planned subacute admissions to an outpatient department.
All acute admissions to the medical department during two six-day periods were registered. The department's registrars filled in a structured questionnaire and the senior registrars evaluated the admissions. In addition, a local general practitioner evaluated one-third of the admissions.
Altogether, 214 consecutive patients were entered in the study. One-third of the patients had consulted their GP in the week before the admission. Admissions from the casualty department and from GPs were assessed as appropriate in 92% and 71% of the cases, respectively. The senior registrars assessed that 17-20% of the acute admissions could have been replaced by a subacute, planned admission. Only 5% of the patients shared this conclusion. The ability to predict the total length of stay was limited, and greatest accuracy was achieved in prediction of short-term stays.
In a medical department with many acute admissions, it is possible to replace acute admissions with planned subacute admissions for a large group of patients.
According to a new EU Directive investigator initiated drug trials are to comply with the guidelines for Good Clinical Practice (GCP) as of May 2004. This implies that trials should be conducted according to a set of Standard Operating Procedures (SOPs) and be subject to monitoring and auditing. In 2001, investigators in Denmark initiated 73 drug trials. In order to provide GCP services and guidance to the investigators it is proposed to establish 3-4 regional GCP units at the three university hospitals. The estimated annual cost for the 3-4 GCP units will be between DDK 7.5 and 10 million.