The Middleton Lodge [ML] practice has 11,136 registered patients and serves an ex mining community with surrounding rural villages. Two local district hospitals provide emergency admission services to patients of the ML practice - King's Mill Centre [KMC] and Bassetlaw Hospital [BDGH].
These hospitals provided computer generated lists of all patients of the ML practice who had been admitted to hospital as an emergency (general medical or paediatric) from October 1st 1998 to March 31st 1999 inclusive.
A report form was designed (Microsoft Works 3.0b database) for recording and analyzing relevant patient and admission details. The GP medical records (including those of patients who had subsequently died) were retrieved and searched by one partner (HW) for the relevant information. For each admission a retrospective subjective judgment was made (by HW), on examining the records, as to whether an admission might have been avoided by either Nursing Home admission or by a change in the GP clinical management of the patient.
The information provided by KMC and BDGH allowed calculation of the admission rate per 1,000 registered patients for the ML practice. In order to compare these rates with those for other local practices, KMC and BDGH provided emergency admission rate information for several local group practices who admit to these hospitals. The information about other practices was anonymised, and covered three winters, meaning October to March inclusive, for the seasons of 97/98, 98/99 and 99/00.