Does a general practitioner support unit reduce admissions following medical referrals from general practitioners?

BACKGROUND Emergency medical admissions to UK hospitals have been increasing steadily over the past few decades and there are likely to be a proportion of these admissions that are avoidable. This evaluation aims to demonstrate whether a general practitioner support unit (GPSU) reduces general practitioner (GP) referred emergency medical admissions to an acute hospital. METHODS The GPSU comprises a team of GPs based in the hospital with the purpose of providing alternatives to admission for medical referrals from community GPs. This is an observational study of patients referred and admitted to the Medical Admissions Unit (MAU) of an acute hospital over two six-month periods, in 2007 prior to and in 2008 after the introduction of the GPSU. RESULTS The number of GP referrals to the MAU per day decreased by 1.55 (confidence interval -2.45 to -0.51) patients with the GPSU in place. The number admitted to the hospital per day from MAU decreased by a mean of 0.48 patients but with confidence intervals that included the null hypothesis (-1.39 to 0.44). In comparison, non-GP admissions that were not targeted by the GPSU increased by 3.99 per day (2.64 to 5.33). CONCLUSION An acute GP led service run from within the hospital to provide support to community GPs led to a modest reduction in the number of GP admissions to the MAU, but did not reduce the number of GP admissions to the hospital wards.