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Purpose

The purpose of this study is to explore the patterns of referral, reasons for admission or discharge from acute medical assessment/admission units (AMAUs) and the reasons for longer length of stay.

Design/methodology/approach

Details relating to consecutive patients were noted on a proforma by medical and nursing staff and were recorded over a three‐month period in 1638 patients. These included evidence of chronicity of disease, level of independence and recent contact with primary care services.

Findings

Age is an important factor in deciding admission or discharge. There is evidence that an opportunity for early intervention, to prevent admission, exists in a significant proportion of patients.

Practical implications

There is a need to develop a more integrated health care system to provide a more co‐ordinated approach to acute medical patients needs, keeping people in their own homes whenever possible.

Originality/value

The increasing number of acute medical admissions provides a challenge throughout the UK. This paper delineates the problem in a typical District General Hospital (DGH) and discusses approaches to decrease admission whilst improving patient care.

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