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Fast-track total knee arthroplasty (TKA) is a well-established concept including optimized logistics and evidence-based treatment, focusing on minimizing surgical stress and improved post-operative recovery, thus leading to lower mortality and morbidity as well as high patient satisfaction. All patients are eligible for fast-track TKA, and hence the fast-track concept should be standard at all joint replacement facilities. Future challenges of fast-track TKA include safe introduction of outpatient protocols, acute and chronic pain after surgery and optimal utilization of post-operative physiotherapy.

A nine day-old girl was hospitalised because of breast-feeding problems and life-threatening hypernatremic dehydration; weight loss was 30% of birth weight and s-Na 187 mmol/l. The question is raised whether there could be an association to the current changes in the perinatal health care in Denmark. The case emphasizes the necessity of a sufficient safety net beneath the newborn children in order to minimise the risk of breast-feeding problems and re-hospitalizing. Neonatal problems such as marked weight loss, dehydration, hypernatremia and marked jaundice are potentially preventable.

Introduction: Nursing home residents represent the majority of hip fracture hospitalisation cases. Quick discharge to nursing homes after surgery is common practice. A previous study indicates an increased risk of death immediately after discharge., Material and Methods: A total of 211 residents, hospitalised from nursing homes for hip fracture surgery, were selected for a retrospective follow-up study. The orthopaedic ward's geriatric team (GO-team) visited the residents no later than one day after discharge. The number of visits depended on the need for treatment and rehabilitation. Intervention was, among others, focussed on: nutrition, fluid therapy and blood transfusion., Results: Intensive geriatric intervention reduced the 30-day mortality (odds ratio (OR) = 0.08; 95% confidence interval (CI): 0.01; 0.52) and reduced 3-month mortality (OR = 0.03; 95% CI: 0.003; 0.25). Fluid therapy and nutritional support were associated with reduced probability of death (OR = 0.12; 95% CI: 0.02; 0.67)/(OR = 0.23; 95% CI: 0.07; 0.79). Non-elective readmissions were reduced (OR = 0.20; 95% CI: 0.04; 0.91). Post-surgical blood transfusion was associated with improved functional ability (beta = 8.22; 95% CI: 1.44; 15.0)., Conclusion: Geriatric interdisciplinary intervention among residents in nursing homes has a positive effect and improves survival and reduces non-elective readmission within three months. Still, there is uncertainty about the effect of fluid therapy and blood transfusions and further investigations are needed.

Introduction: Hip fracture is the most common cause of long hospitalisation among elderly and is increasing in the group of elderly aged 85+ years. Hip fractures are associated with a host of factors and mainly caused by falls and osteoporosis., Material and Methods: The Geriatric Team of the orthopaedic ward, geriatric rehabilitation and follow-home function (GO) is compared to traditional orthopaedic treatment (ORT) among elderly aged 65+ with respect to: haemoglobin difference before surgery and 3-6 months after fracture, osteoporosis treatment, length of stay, change in accommodation, readmission and mortality within six months after admission and incidence of new fracture within two years., Results: Median length of stay was reduced from 15 till 13 days. Significantly more were treated with calcium/D-vitamin and bisphosphonate. The risk of a new fracture within two years was lower (incidence rate ratio = 0,72 (95% confidence interval (CI: 0,39-1,32)). Geriatric intervention did not reduce readmission (odds ratio (OR)= 1,09 (95% CI: 0,71-1,67)) and mortality (OR = 1,22 (95% CI: 0,71-2,11))., Conclusion: A combined geriatric orthopaedic effort in elderly with hip fracture seems to improve the quality as well as the efficiency of treatment. The concept would benefit from further development and combination with other initiatives aimed at accelerating the treatment pathway of the elderly.

Background: The organisation, volume and early morbidity after radical prostatectomy has not been researched in Denmark., Materials and Methods: The National Hospital Register was searched for all radical prostatectomies in Denmark from 2004-2007, including mortality and readmissions., Results: In total, 1469 radical prostatectomies were performed, initially in 9 departments, decreasing to 6 departments in 2007. From 2004 to 2007 the number of operations increased by approximately 60%. Median hospital stay was 4 days (mean 5.1 days) without any differences between departments. Mortality was 0.2%., Conclusion: There is an increasing rate of radical prostatectomies in Denmark. It is proposed that a national database be established to monitor early and long-term outcomes, including the role of surgical technique (nerve sparing, laparoscopic/robotic surgery, etc.) in order to ensure optimal organisation.

Introduction: Restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA) has become the operation of choice for patients with ulcerative colitis and familial polyposis. However, the procedure is complex with a long learning curve, and carries a risk of both early and late complications. The purpose of this study was to evaluate the early outcomes (within 30 days after surgery) and organisation of IPAA surgery in Denmark between January 2001 and December 2005., Materials and Methods: IPAA patients >18 years old were drawn from the Danish National Patient Registry from 2001 through 2005. Hospital stay and the primary operation were recorded as well as re-operations and readmissions within the first 30 postoperative days. Mortality was recorded from the National Civic Register., Results: 385 patients underwent IPAA surgery during the study period (77/year) in six centres. One centre performed 31% of the operations. The mean postoperative hospital stay (primary - and readmission within 30 days) was 13.5 days. 24% were readmitted within 30 days and 8% were re-operated. The mortality rate was 0.3%., Conclusion: Based upon the limited number of operations, the high risk of early readmissions and re-operations, the well-known steep learning curve and the potential improvement with the technically demanding laparoscopic technique, a reorganisation of the procedure to fewer centres is suggested.

Introduction: The aim of this study was to investigate the cholecystectomy rate and rate of gallstone-related complications in patients formerly seen and discharged without operation from the Clinic for Day-Surgery, Glostrup University Hospital, Denmark., Materials and Methods: From January 2000 to December 2002 a total of 222 patients with gallstones were discharged without operation (lap. cholecystectomy) from the day-surgery clinic. All admittances and surgical procedures in the follow-up period were identified by reading patient files and strategic searches in the National Patient Register in which all operations in Denmark are registered., Results: The median follow-up period was 37 months (range 5-62 months). 25% of patients were operated in the follow-up period (cholecystectomy, n = 54, gallstone ileus, n=1). 13% had gallstone-related complications in the follow-up period. 9 patients had one or more endoscopic retrograde cholangiographies. There was no mortality or serious surgical complications., Conclusion: There is a lack of objective criteria for cholecystectomy in symptomatic cholecystolithiasis. The national guidelines in Denmark advocate cholecystectomy only in patients with socially disabling pain attacks. These guidelines are followed in our department and the strategy seems acceptable and patient-friendly, although the optimal treatment strategy for patients with symptomatic gallstone disease is still unknown.

Background: The study was conducted to investigate the safety of "hospital at home" versus hospital care., Materials and Methods: It was a prospective randomised controlled trial. Patients with an exacerbation of chronic obstructive pulmonary disease (COPD) were included and randomised to supported discharge (n = 22) or to conventional in-patient care (n = 22). Outcome measures were readmissions, complications, mortality within 60 days of initial admission., Results: 390 patients (COPD) were admitted and 44 patients (12%) were included in the study. In the home treatment period 2 patients (9%) were readmitted. One patient (4.5%) died 2 weeks after discharge from the home treatment. In the follow-up period 3 patients in the home treated group were readmitted 7 times (31.8%), and 7 patients in the conventional in-patient group were readmitted 9 times (40.9%). There were 14 complications (63.6%) in the home treated group and 15 complications (68.3%) in the conventional in-patient group. The length of hospital stays in the supported discharged group were shorter (1.3 (std = 0.5) versus 3.7 (std = 2.8) days, p = 0.002). After discharge a respiratory nurse visited supported discharged patients at home during 5.1 days (min. 2 days, max. 13 days) with 2.6 visits per patient (min. 1, max 6 visits)., Conclusion: This study shows that home supported discharge is a well tolerated, safe and economic alternative to hospital admission for a proportion of patients referred to hospital for admission for COPD.

Introduction: Introduction of principles for postoperative multimodal rehabilitation (fast track surgery) has decreased hospital stay from about 8-10 days to 2-4 days after colonic resection. The aim of this study was to investigate the effect of a similar fast track regimen in patients operated for ovarian cancer., Method: 72 consecutive patients operated with a conventional perioperative treatment regimen (group 1) were compared with the initial 69 consecutive patients (group 2) with a multimodal rehabilitation regimen and the next 50 consecutive patients (group 3) where the fast track regimen was implemented as a routine., Results: Patients demographics and surgical characteristics were comparable between groups. Median postoperative hospital stay was reduced from six days in group 1, to five days in group 2, and four days in group 3 (p < 0,05). Surgical complications were similar while medical complications were reduced from 12% to 1% (p < 0,05) and readmissions from 10% to 2% (p < 0,05) with the fast track regimen., Conclusion: Principles for postoperative multimodal rehabilitation from colonic surgery lead to faster rehabilitation, decreased risk of medical complications and hospital stay in patients operated for ovarian cancer.

Introduction: A Crisis Home programme inspired by the principles of the Assertive Community Treatment (ACT) model in U.S. psychiatry, in which adult psychiatric patients, as an alternative to admission to hospital, spend some time in a private family has been implemented at the Community Mental Health (CMH) Centre in Tonder., Materials and Methods: Procedures and schedules from the Crisis Home programme, Madison, were analysed. Data obtained at the start and end of each patient's stay were supplemented with register data on the consumption of mental hospital benefits. Qualitative data were obtained through focus group interviews., Results: From 1 July 2001 to 30 June 2003, 41 patients made a total of 96 stays in a Crisis Home. Eight of the patients made more than 3 stays. Seventeen (41.5%) of the patients were attached to the CMH Centre's ACT team. These patients accounted for 43.8% of the stays. The average duration of the stays was 4.4 days. The number of patient readmissions after the first stay in a Crisis Home showed a downward tendency. The patients, the Crisis Home families and the associated professionals were all very satisfied with the programme., Discussion: The possibility to stay in a Crisis Home has the potential to ameliorate the condition and reduce the risk of readmission of patients suffering from severe mental illness. We suggest that a stay in a Crisis Home represents an improvement in quality of the total treatment package; however, further documentation, including of the health economic aspects, will require a randomised trial.

Introduction: The aim of this study was to describe our experience with laparoscopic cholecystectomy as an outpatient procedure in terms of complications, same-day discharge, and a registration of patient' postoperative pain, convalescence and contact with general practitioners., Materials and Methods: A prospective evaluation was done of the first 231 patients undergoing laparoscopic cholecystectomy in an outpatient clinic., Results: Ninety per cent of the patients were discharged directly from the outpatient clinic, and a total of 93% of the patients were discharged within 24 hours of the operation. The readmission rate was 1%. Leakage from the cystic duct occurred in one case (0.4%), and no other injuries to the bile ducts were observed. The conversion rate was 1%. Within a week 54% of the patients had no pain and 55% of the patients had resumed normal activity. Postoperatively, 25% of the patients had contact with a general practitioner due to wound and other complaints that required no intervention., Discussion: Laparoscopic cholecystectomy is very suitable as an outpatient procedure due to its high same-day discharge rate and high patient satisfaction combined with low readmission and complication rates. Our study did expose, however, a high number of postoperative contacts with general practitioners due to non-surgical problems, which emphasizes the need for better patient information and cooperation with general practitioners to optimize the outpatient procedure further.

Introduction: By careful selection of both patients and surgeon, outpatient laparoscopic cholecystectomy can be performed in up to 90% of elective patients. The rate of same-day discharge in an unselected group scheduled for elective operation is, however, not clarified., Materials and Methods: A clinical pathway for outpatient laparoscopic cholecystectomy was introduced as the standard procedure for all patients undergoing elective operation. The set-up allowed easy access to an overnight stay if needed. Hospital stay, complications, reasons for admittance, the need for medical advice after discharge, convalescence and patients" satisfaction were analysed. Prospective registrations were undertaken in a standard care plan, and a questionnaire was sent out after four weeks., Results: During two years of the study, 535 patients had a cholecystectomy done. Of these, 403 were scheduled for elective laparoscopic operation and entered the clinical pathway. In 62% of the patients, the outpatient course was successfully completed, and 94% of the patients were discharged within 24 hours. In 2%, complications resulted in hospital stays longer than three days, and 2.7% of the operations were converted. About one third of the patients needed additional medical advice after discharge, and 4.3% of these were readmitted. Pain was among the most frequent complaints. The patients" satisfaction with the procedure was approximately 90%., Discussion: In an unselected group of patients scheduled for elective laparoscopic cholecystectomy, about two thirds can be treated as outpatients with a high degree of safety and patients" satisfaction. Further development, especially in the multimodal treatment of pain, is still the most important area to focus on in order to reduce postoperative complaints and improve the course of convalescence.

Introduction: This cross-sectional study describes quality related data from 39 medical wards in Denmark., Material and Methods: The study is based on a review of 1517 medical records and a short patient interview. The medical departments took part voluntarily in the study, which was initiated by the Danish Society for Internal Medicine., Results: A total of 23 quality-related indicators related to the planning of the treatment, documentation in patient records, and care were registered. The day before the data collection was an inactive inpatient day for 22.8 +/- 1.1% of patients. Allergy was insufficiently documented in the medical record for 18.8 +/- 1.0% of patients. Weight was not documented in 48.8 +/- 1.3% of patients. Considerations about anticoagulation treatment of atrial fibrillation were not documented in 50.1 +/- 3.6% of patients with atrial fibrillation., Discussion: This study indicates that it is possible on a voluntary basis to collect and distribute quality-related data. The survey has recently been repeated with a modified data registration sheet.

Introduction: We wanted to assess postoperative pain relief and functional improvement in all CABG patients (546) from Gentofte County Hospital (GCH) in 1997, so as to elicit better information on what to expect after CABG., Material and Methods: A descriptive cross-sectional survey, was carried out in 1999. All surviving patients (527) were sent a questionnaire with 17 questions in five categories: The course of the operation, pain level, medicine consumption postoperatively, working situation, and educational level. The inclusion criterion was CABG in GCH in 1997., Results: One hundred and five women and 441 men (mean age 74 and 67 years) were entered. Response rate: 98%. Mortality rate: 0.9% in 30 days and 3.5% in two years. Sixty-four percent were satisfied with the course of the operation. In two years 33% were rehospitalised and 6% had a new CABG/PTCA. Other frequent diagnoses for readmission were AMI, arrhythmia, and angina. Considerable wound discomfort was reported by 21% (chest) and 13% (leg/arm). Marked pain relief and functional improvement was achieved postoperatively (95%). Postoperative angina was not associated with limitation in daily activities. Postoperative medicine consumption: 52% antihypertensives and 20% anti-angina medicine. The return-to-work rate, for those working before the operation was 75% in about two months, with a slight preponderance in those employed in the private sector., Discussion: The study shows a high survival rate in two years after CABG. Considerable pain relief and functional improvement was achieved, and only a very small group derived no benefit from the operation. A large amount of patients had wound discomfort, which leaves an unsolved problem.

Introduction: The aim of the study was to describe the organisation of laparoscopic cholecystectomy in outpatient surgery and to discuss whether the method should be the future treatment of choice., Material and Methods: A retrospective descriptive study was carried out on 133 consecutive patients in the period 1 October 1999 to 30 September 2000., Results: Seventy-seven per cent of the patients were discharged directly from the Department of Outpatient Surgery and 121 (97%) who underwent laparoscopy were discharged within 23 hours of the operation. The postoperative complication rate was 1.5% and the frequency of readmittance was 5%., Discussion: Laparoscopic cholecystectomy is suitable for outpatient surgery and appears to be a recommendable setting for this operation. The method is safe and associated with few complications and readmittances.

Introduction: The incidence and length of postoperative stay in hospital in Denmark after oesophageal reflux surgery has not been described previously., Material and Methods: We examined the national patient hospital register and discharge information from the hospitals for the number of reflux operations carried out, the length of postoperative hospital stay, readmissions, and postoperative complications occurring within 30 days in the period, 1997-1999., Results: Twenty-four departments performed 4.9 operations/100,000 inhabitants per year, corresponding to 788 operations. The postoperative 30-day mortality was 0.4% and 6.6% of the operations were followed by serious surgical complications. The combined primary + readmission hospital stay was 3.7 days in the first postoperative month., Discussion: The small number of oesophageal reflux operations performed in many departments in Denmark is not in agreement with the Danish National Board of Health recommendations from 1996, which say that the operations should be done in only five departments. The spreading of surgery means that only few surgeons can reach sufficient training of surgery and that statistical comparison between the departments of the early results of treatment is not meaningful. Overall, national results are comparable to international results. The incidence of oesophageal reflux surgery is about three times lower than in other Scandinavian countries. On these results, it is recommended that the operation is performed in fewer departments and by fewer surgeons.

Introduction: There are long-term patients in psychiatric hospitals, who are often referred to as new long-stay patients: the heavy users consumers of psychiatric services and difficult-to-place patients., Material and Method: Social characteristics, diagnosis, need for care, function, and admission patterns were compared in a group of heavy user patients (N = 39) and a group of difficult-to-place patients (N = 14)., Results and Discussion: The difficult-to-place patients were more often men, more often had a diagnosis of schizophrenia, had a lower socio-economic status, and lower GAF scores. The difficult-to-place patients rated the same amount of need for care as did the heavy users, but were assessed by the staff to have a greater need for care. The results support the view that the difficult-to-place patients comprise a distinct group. Services for the difficult-to-place patients must combine highly differentiated care with few demands and greater tolerance with respect to problem behaviour.

Introduction: Due to a rather high complication rate, we decided to analyze data from women, who were readmitted to hospital with complications to legal abortion., Material: 760 legal abortions performed in 1993-1994 were retrospectively reviewed for complications., Results: We found 66 complications (8.7% (95% confidence limits (6.7-10.7)), that resulted in readmission to hospital. The distribution of complications was as follows: retention 41 (62% (50-74)), infection 12 (18% (9-27)), bleeding and pain 11 (17% (8-26)) and perforation two (3% (0-7)). There was a slight correlation between a stronger midline echo on ultrasound measurement of the uterine cavity and finding placental tissue on histological examination of the material obtained from reevacuation. The time interval between legal abortion and reevacuation was nine days. Retroflexio uteri was not correlated with reevacuation., Conclusions: We found a statistically increased risk of complications following legal abortion relative to the figures reported by the national health authority, but not significantly higher than that found in other reports. Moreover, a conservative attitude to retention can reduce the number of reevacuatio uteri after legal abortion.

The aim of the present study was to produce a nation-wide quantitative description of re-admissions for schizophrenia in Denmark in the period 1979-1998. The study is based on anonymous data from the Psychiatric Central Register. All persons with a main diagnosis of schizophrenia are included. The number of re-admissions of schizophrenics has constantly increased since 1979 (approx. 65%), and the number of persons who account for these re-admissions has increased by approximately 55%. Patients who for the first time are diagnosed with schizophrenia have in the first year after the first admission an average risk of re-admission of 50%, a risk that has not decreased during the 20 years studied. The median age of re-admitted patients has increased by five years for males and is almost unchanged for females indicating a continuous need for re-admission of schizophrenic patients, also the older patients. Danish psychiatry has each year contact with approximately 50% of the persons who at least once have been diagnosed with schizophrenia since 1969 and who are still alive. Certain precautions must be taken in the interpretations of general aggregated statistics such as these.

The object of the study was to investigate the significance of quality assurance of treatment and care for schizophrenic patients in relation to psychosocial functioning and prognosis. In a period of one year prior to the quality assurance, quality measurements were carried out on 53 schizophrenic patients. Then quality standards with structure, process- and result criteria were implemented, and quality measurements for 57 patients admitted after the implementation were carried out. At admission there was no significant differences between the two groups. Before the implementation of quality standards, the patients did not regain their habitual level of psychosocial functioning (measured by the GAF-scale) at discharge. After the implementation the patients regained their habitual level. After implementation there was a significant lower rate of readmissions. Due to the fact that readmission is identical with relapse, the quality improvement therefore improved the prognosis for the schizophrenic patients.

The annual number of registered drug abusers in The Danish National Patient Register has been stable as to age and gender in the period of investigation. The patients registered as drug abusers are often polydrug abusers or abusers of illegal drugs. A large proportion of the patients have previously been admitted to a psychiatric department. The ten most common comorbid diseases found among registered drug abusers are all associated to drug abuse. Older drug abusers and abusers with a comorbid disease utilize more bed days than other groups of drug abusers. The number of registrations of abuse at re-admission of the patients within a period of three years after their first drug abuse diagnosis is considerably lower than expected because the abuse has ceased. It is absolutely possible that drug abuse is underdiagnosed among somatic patients in general hospitals in Denmark.

The aim of this study was to describe the results of laparoscopic cholecystectomy as an outpatient procedure in a prospective, consecutive, descriptive study. The study included 50 patients selected in the period from April to December 1997, who accepted the outpatient procedure. Preoperative complications, morbidity during hospital stay, length of hospital stay, frequency of readmission and the satisfaction of the patients were registered. In our investigation we found a risk of preoperative complications of 6% (severe 0%), a morbidity during hospital stay of 6% (severe 2%) and an incidence of readmission of 4%. A total of 74% of the patient went home on the same day as the procedure, and 90% of all patients had been discharged 24 hours later. The patients showed a high degree of satisfaction. In conclusion laparoscopic cholecystectomy as an outpatient procedure may be performed with a low risk of complications, a low incidence of readmission, a high degree of satisfaction in patients, but with a high frequency of primary admission (26%).

A total of 546 children and adolescents, aged 5 to 15 years, who were admitted as in-patients to psychiatric hospitals throughout Denmark between 1970 and 1973, were followed up regarding to later readmissions and mortality. Approximately one-third of the sample had at least one readmission after the age of 18 years: there was no significant difference between male and female subjects. Probands with three selected diagnoses, namely childhood neurosis, conduct disorder and maladjustment reactions, had a significantly greater general risk of readmission to psychiatric hospital in adulthood than the background population. In total, 24 probands (22 male, and 2 female subjects) died during the study period. Eight subjects had committed suicide. The standard mortality rate was significantly increased.

The aim of the study was to investigate factors of significance for readmission of patients in a department of internal medicine. The study was based on hospital computerized data files. All admissions from the 1st of January to the 31st of December 1995 were included. During that period the department had 6061 admissions of 4152 patients. The readmission rate was 1.46. All patients were followed three months after discharge. Within that period 1119 (27%) of the patients were readmitted. A high frequency of readmission was especially found within the first ten days after discharge. Length of stay in hospital did not influence readmission rate. Women, patients in the age group 71-90 years and patients with chronic diseases were more likely to be readmitted. The demonstrated factors relating to a high readmission rate are difficult to influence. A prospective study including the primary health care system and a clinical evaluation of the patients is needed to examine causes of the high number of readmission within the first ten days after discharge.

The aim of the study was to evaluate if an experienced reduction in length of stay in a geriatric department had negative influence on rehabilitation in terms of more readmissions, nursing home replacements or deaths in the first six months after discharge from the geriatric department. In a retrospective study all inpatients discharged from geriatric department RL, Kommunehospitalet, in the first six months of 1990 and 1992 respectively were evaluated. The main contributor to reduction in hospital length of stay was found to be an earlier geriatric intervention combined with shorter waiting time for transfer to the geriatric department. In the study populations we found no significant difference in the number and time of readmissions, the number of nursing home replacements or deaths in the first six months after discharge. Short length of stay is not in itself an aim of a geriatric department. We conclude that geriatric assessment should take place as soon as possible after admission to hospital and acute/subacute admission to the geriatric department is to be intensified.

The purpose of this investigation was to investigate how often psychiatric patients changed diagnosis on readmission to hospitals. On the basis of the most recent discharge diagnosis it was registered how many patients who had been diagnosed in other major diagnostic groups over a 10-year period, and a mobility of 40.6% was found. By comparison with other investigations it was shown, that the changes most often took place in the first two years. The mobility was most marked for the neurosis-group and was approximately uniform for the other groups.

The object of this investigation is to illustrate the effect of intensive social assistance at and after discharge from hospital and, if possible, to present some practical proposals. The investigation was controlled: 100 patients domiciled in two communities in the catchment region of the hospital participated in the investigation. The patients were aged 25-75 years and they were discharged from a neuromedical inpatient department. These were subdivided at random into an intervention and a control group. The investigation comprises interviews with the patients, questionnaires to the general practitioners and the social and health authorities. Intervention was undertaken for five months in one of the groups in cooperation with the general practitioner. Although the intervention revealed that there were numerous unsolved problems and that patients with poor ability were left to themselves to a great extent, the intervention did not result in any measurable difference in patient satisfaction as compared with the control group. No readmissions occurred on account of social reasons in the intervention group. A series of planned forms of assistance did not function on discharge. The fact that patients are discharged earlier in the course of the condition than previously is considered to be the cause of a number of the unsolved problems. At the conclusion of the investigation, there were more numerous unsolved problems in the control group than in the intervention group and the need for advice and support, not only for the patients but also for the relatives, which was considerable after discharge, was documented. This need has not fulfilled and proposals are discussed.

The object of this investigation was to describe the health and social medical conditions of elderly readmitted patients and to assess which of these conditions was the main reason for readmission. A total of 166 patients (with an average age of 73 years) who were readmitted to the ward within three months of the previous discharge were interviewed about their health, social and housing conditions during the period prior to admission. The interviews were conducted in the second half of 1987. In this second report from the investigation it was found that 84% lived in flats with good facilities. 50% lived alone, 57% received at least one form of public assistance (ie home help, home nursing etc.). The interviewers considered that social and housing conditions were the only reason for 12% of the readmissions and were contributory causes in 15% of the readmissions. It is concluded that health reasons were the primary reasons for the present readmission.

The object of this investigation was to describe the health and social-medical conditions of readmitted patients and to assess which of these conditions was the main reason for readmission. A total of 166 patients (with an average age of 73 years) readmitted to the ward within three months of the last discharge from the ward were interviewed about their health, social and housing conditions in the period prior to admission. In this first report from the investigation it was found that 57% were readmitted within one month. 71% stated that they had experienced symptoms from the heart and/or respiratory system and 52% had experienced symptoms from the locomotor system. Only 13% did not receive any daily prescription drugs. Approximately 1/3 considered their health to be good and 1/3 poor, respectively. These results were compared with the data available in the literature about the health conditions of non-hospitalized elderly persons. It was demonstrated that the readmitted patients had more health complaints, a more extensive medication and considered their health worse.