Community hospitals - A study in resource use, decision making and patient outcome

Grant, James Alexander (2002) Community hospitals - A study in resource use, decision making and patient outcome. MD thesis, University of Glasgow.

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Abstract

This thesis examines the proposition that community hospitals are an undervalued health service resource particularly in regards to the care of the elderly. It is known that the types of patient admitted for community hospital inpatient care are predominately, but not exclusively, elderly. There is a general lack of research on all aspects of community hospital functioning. There use is highly variable but we lack insights into why this is the case. There is little detailed knowledge around the complex mixture of medical and social factors involved which can provoke admission. Similarly little is known about the relationships between the care received and the outcomes of that care. This thesis addresses some of these issues by means of three well defined but related studies carried out in the five community hospitals in Perth and Kinross. It also considers the proposition that only by addressing the educational and access issues surrounding community hospital care will it be possible to increase usage and deliver more appropriate care in the long term. Several descriptive studies have been published on community hospital role and function suggesting that they can have significant part to play in the provision and delivery of community health care. (Cavenagh 1978; Grant 1984; Tucker 1987). Yet, despite these apparent endorsements, community hospitals have continued to function between the conventional primary and secondary care pillars of the NHS without achieving widespread acceptance as significant service providers in a modem health service Previous work by the author described the scope of community hospital provision in Scotland. The role of the community hospital in the provision of specific areas of care such as casualty services and the care of myocardial infarction has also been examined. Throughout these studies the educational issues surrounding the community hospital, both in terms of the needs of those working in them and the potential they offered as a resource for medical and nursing education, has been a recurring theme.

Item Type: Thesis (MD)
Qualification Level: Doctoral
Additional Information: Adviser: Frank Sullivan
Keywords: Health care management
Date of Award: 2002
Depositing User: Enlighten Team
Unique ID: glathesis:2002-71907
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 17 May 2019 09:31
Last Modified: 17 May 2019 09:31
URI: http://theses.gla.ac.uk/id/eprint/71907

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