Emergency admissions to a geriatric medical unit.

DIRECT admission of patients from home is the predominant method of admission to geriatric medical units. Admission may take place as the result of a telephone consultation with the general practitioner or, in less urgent cases, following a domiciliary assessment visit by a member of the medical staff of the unit. However, in recent years the pattern of referral to hospitals in Belfast has changed. This has been brought about by the simultaneous development of general practitioner deputizing services and the emergency bed service. As a result, many more elderly patients are admitted from the casualty department without direct contact between the family doctor and the hospital medical staff. As it has been the custom for general medical units to accept all medical admissions from the casualty department, this has resulted in a change in the pattern of admission to both the geriatric medical and general medical units. To take account of this change in referral pattern it was decided to start a system of direct admissions from the casualty department to the geriatric medical unit of the Belfast City Hospital. This paper describes the results of the first year's working of this system.