ABSTRACT
Hospital admission is a significant and potentially costly event for both patients and the health service. Hospital admission can be a traumatic adverse life event, particularly for the elderly. Emergency admissions have even greater impact than arranged admissions because of their unplanned and unpredictable nature. Variance in medical practice has been observed in virtually all areas studied and provokes concern as to its implications for quality of care and efficient use of resources. Emergency admission rates have been rising steadily in recent years, with the majority of the increase due to emergency medical admissions. This study suggests that patient factors, particularly age and deprivation, are the biggest determinants in variations between general practices’ emergency admission rates. Doctor factors are unlikely to have a significant impact on emergency medical admissions at a population level. Attempts to blame doctors for the rising tide of emergency medical admissions will be fruitless.
