Summary of responses by vignette.
| Vignette | Admission deemed inappropriate, n/N (%) | Problem could be managed in care-home or as an outpatient, n/N (%) | Admission not appropriate for the individual patient, n/N (%) |
|---|---|---|---|
| 1: advanced dementia with behavioural disturbance | |||
| Overall | 47/50 (94) | 44/47 (94) | 47/47 (100) |
| Primary care | 18/18 (100) | – | – |
| Secondary care | 29/32 (91) | – | – |
| 2: reduced mobility and hip pain in a patient with dementia | |||
| Overall | 14/50 (28) | 9/14 (64) | 9/14 (64) |
| Primary care | 5/18 (28) | – | – |
| Secondary care | 9/32 (28) | – | – |
| 3: dementia with loss of safe swallow | |||
| Overall | 34/50 (68) | 29/34 (85) | 32/34 (94) |
| Primary care | 16/18 (89) | – | – |
| Secondary care | 18/32 (56) | – | – |
| 4: exacerbation of chronic condition (chronic obstructive pulmonary disease) | |||
| Overall | 20/50 (40) | 18/20 (90) | 17/20 (85) |
| Primary care | 9/18 (50) | – | – |
| Secondary care | 11/32 (34) | – | – |
| 5: acute problem requiring procedural skill (urinary retention) | |||
| Overall | 26/50 (52) | 24/26 (92) | 21/26 (81) |
| Primary care | 10/18 (56) | – | – |
| Secondary care | 16/32 (50) | – | – |
| 6: exacerbation of chronic condition (single self-terminating seizure in patient with epilepsy) | |||
| Overall | 25/48 (52) | 21/25 (84) | 20/25 (80) |
| Primary care | 10/18 (56) | – | – |
| Secondary care | 15/30 (50) | – | – |
| 7: probable iatrogenic harm (minor haematemesis in patient with polypharmacy) | |||
| Overall | 21/48 (44) | 16/21 (76) | 20/21 (95) |
| Primary care | 10/17 (59) | – | – |
| Secondary care | 11/29 (38) | – | – |
| All combined | |||
| Overall | 189/346 (55) | 161/189 (85) | 166/189 (88) |
| Primary care | 78/125 (62) | – | – |
| Secondary care | 109/221 (49) | – | – |
Data are n/N (%). Primary care includes care-home-liaison nurses and specialist GPs; secondary care includes emergency medicine specialists, geriatricians and general medical physicians. In columns three and four, only responses by those who deemed the admission inappropriate are included.