The Health service journal
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A trust, comprising two hospitals, has reduced the mean length of stay for acute medical admissions from 11.1 to 10.5 days and the median from six to five days, despite an increase in the number of these admissions. Providing medical teams with unanonymised information on their length of stay profiles has helped achieve this. ⋯ In considering length of stay it is useful to look at the mode or peak, as well as the mean. This is because the mean is heavily influenced by the small number of patients who stay in hospital for a very long time.
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Managed care in the US reduces use of health services and hospital admissions. Concerns that cost control could jeopardize quality are widespread. ⋯ Managed care produces low patient satisfaction ratings. The US evidence on managed care has little direct relevance to the UK, but elements of it might be usefully tested here.
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A decrease in surgical beds left a trust insufficient flexibility to increase an already high throughput without affecting the quality of care. Changes in the management of surgical admissions, including the appointment of an admissions co-ordinator, have improved co-ordination of elective and emergency admissions. Three years later maximum waiting times had fallen from 18 to 10 months. In the first nine months of the new booking system, the number of operations cancelled on the day because of bed nonavailability fell by half, while patients cancelled on the day of admission dropped by 36 per cent.