The Finnmark general practitioner hospital study. Patient characteristics, patient flow and alternative care level.

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In a study assessing the role of general practitioner hospitals (GPHs) in the health service two main questions were addressed: 1) Are general practitioner beds used for short-term medical observations, or as a supplement for long-term geriatric care? 2) What are the alternatives to stays in GPHs? In a prospective design GPH stays during 8 weeks were recorded. 15 GPH units in Finnmark county in Norway. 395 completed stays were recorded. The patients' sex, age and diagnosis, flow of patients, length of stays, bed occupancy rate, and doctors' assessments of alternative level of care. 60% of the patients were admitted from and discharged to their home after a mean stay of 6.8 days. The 19% who were transferred to higher level hospitals stayed significantly shorter than the rest (3.6 days), while 9% transferred from hospital stayed significantly longer (22.3 days). Of the 395 patients discharged 61% were assessed as candidates for higher level hospitals, if GPHs did not exist. 45% of the GPH stays seem to replace higher level hospital admissions. The GPHs have a pre-hospital "buffer" function by preventing patients with acute symptoms from being unnecessarily admitted to general hospitals through short-term observation stays. A post-hospital function was also demonstrated, since GPHs allow for long-term follow up stays for patients transferred from general hospitals.