Trends in admissions to internal medicine wards in a community hospital in Israel

Background: Epidemiological studies are useful both for investigating possible etiologic factors and for determining the extent of health provisions required. In an attempt to improve the quality of care, we have analyzed the trends of admissions to the four internal medicine wards in a community hospital in Israel. Methods: Data was collected on admission to all of the internal medicine wards of Hasharon Hospital, Rabin Medical Center, Petach-Tikva, Israel, from 1999 to 2004, including discharge diagnosis, duration of stay, and mortality. The data source was the "Bina" data warehouse system of Clalit Health Services. Results: The yearly admission rate was 10,482 ± 386. Ninety-six percent of the admissions were of Jews and 3% were of Arabs. Most of the patients were older than 75 years (43.1%); 23.6% were between 65 and 74 years of age. The readmission rate was 7.4% within 1 week and 16.3% within 1 month. The three most common discharge diagnoses, not including pre-existing illnesses, were: coronary artery disease-related (21.9%), heart failure (5.4%), and pneumonia (5.6%). The average duration of stay was 4.6 ± 0.1 days. Patients admitted for newly diagnosed malignancy, pneumonia, or CVA had a longer duration of stay (7.1, 6.8, and 6.5 days, respectively). There was a steady decline in mortality from 4.5% in 1999 to 4.2% in 2004. Conclusion: In the 5-year period studied, there was a changing trend in mortality rate, hospital duration rate, and patient age.