چکیده (انگلیسی):

Background:Health care professionals in several countries are searching for alternatives to acute hospitalization. In
Hallingdal, Norway, selected acute patients are admitted to a community hospital. The aim of this study was to
analyse whether acute admission to a community hospital as an alternative to a general hospital had any positive
or negative health consequences for the patients.
Methods:Patients intended for acute admission to the local community hospital were asked to join a randomized
controlled trial. One group of the enrolled patients was admitted as planned (group 1, n = 33), while another group
was admitted to the general hospital (group 2, n = 27). Health outcomes were measured by the Nottingham
Extended Activity of Daily Living Questionnaire and by collection of data concerning specialist and community
health care services in a follow-up year.
Results:After one year, no statistical significant differences in the level of daily function was found between group
1 (admissions to the community hospital) and group 2 (admissions to the general hospital). Group 1 had recorded
fewer in-patient days at hospitals and nursing homes, as well as lower use of home nursing, than group 2. For
outpatient referrals, the trend was the opposite. However, the differences between the two groups were not at a
5% level of statistical significance.
Conclusions:No statistical significant differences at a 5% level were found related to health consequences
between the two randomized groups. The study however, indicates a consistent trend of health benefits rather
than risk from acute admissions to a community hospital, as compared to the general hospital. Emergency
admission and treatment at a lower-level facility than the hospital thus appears to be a feasible solution for a
selected group of patients.
Trial registration:ClinicalTrials.gov NCT01069107. Registered 2 April 2010.