How does the hospital admission process work. What are the different types of hospital admissions. What should patients know before being admitted to a hospital. How do public and private hospital admissions differ. What questions should patients ask before starting hospital treatment.

Types of Hospital Admissions: Planned vs. Unplanned

Understanding the various ways patients can be admitted to hospitals is crucial for effective healthcare planning. There are two primary types of hospital admissions: planned and unplanned.

Planned Admissions

Planned admissions, also known as elective admissions, occur when a patient’s hospital stay is scheduled in advance. This typically involves the following steps:

1. A doctor or specialist provides a referral
2. The patient contacts a specialist clinic for an appointment
3. The specialist assesses the patient and may order additional tests
4. A treatment plan is developed, which may include hospitalization
5. The patient is informed about the expected waiting time for treatment

In public hospitals, waiting times for planned surgeries are determined by the urgency of the patient’s condition, as assessed by the admitting specialist. Private hospitals generally offer shorter waiting times and allow patients to choose their treating doctor, but this comes with additional costs.

Unplanned Admissions

Unplanned or urgent admissions occur when a patient requires immediate medical attention. These admissions typically involve:

• Arriving at the hospital via personal transport or ambulance
• Being admitted through the emergency department
• Undergoing triage by a specialist emergency nurse
• Receiving immediate first aid and assessment of treatment urgency
• Possible waiting in the emergency department, depending on the severity of the condition and overall department workload

Public vs. Private Patient Status: Understanding Your Options

When admitted to a hospital, patients often have the choice between public and private patient status. This decision can significantly impact the cost and nature of the care received.

Public Patient Status

As a public patient in a public hospital:

• There are no costs for hospital or medical services
• Patients may not be able to choose their treating specialist
• Waiting times for non-urgent procedures may be longer

Private Patient Status

Opting for private patient status, even in a public hospital:

• Requires payment for some services, either out-of-pocket or through health insurance
• Often allows patients to choose their treating specialist
• May result in shorter waiting times for elective procedures

Why might a patient choose private status in a public hospital? In some cases, public hospitals may have the best equipment, facilities, and specialists for particular health issues or treatments. This option allows patients to access these resources while maintaining some benefits of private care.

The Hospital Stay: From Admission to Discharge

Once admitted, patients are typically placed in a hospital ward. The duration of the stay varies depending on the treatment required:

• Minor procedures may only require a day stay
• Major surgeries or ongoing treatments may necessitate extended stays

During their stay, patients can expect:

1. Regular check-ups by medical staff
2. Administration of prescribed treatments and medications
3. Monitoring of vital signs and recovery progress
4. Coordination with various hospital departments for tests and procedures
5. Discharge planning as the patient’s condition improves

Navigating Emergency Department Admissions

Emergency department admissions involve a unique process designed to prioritize patients based on the severity of their conditions. How does the triage system work in emergency departments?

Triage is a systematic approach to assessing and prioritizing patients in emergency settings. It involves:

• Initial assessment by a specialized triage nurse
• Categorization of patients based on urgency of care needed
• Allocation of resources and attention according to priority

Patients may experience varying wait times in emergency departments. What factors influence these wait times?

• Overall volume of patients in the department
• Availability of medical staff and resources
• Complexity and severity of other patients’ conditions
• Time required for diagnostic tests and results

Essential Questions to Ask Before Hospital Treatment

To make informed decisions about hospital care, patients should ask their doctors several key questions. What are some crucial inquiries to make before starting hospital treatment?

• Can I choose my specialist, and if so, who will it be?
• Which hospital will I be admitted to?
• What is the expected duration of my hospital stay?
• What are my treatment options, and what are the benefits and risks of each?
• What are the potential consequences of not receiving treatment?
• How long is the expected waiting time for my treatment?

By asking these questions, patients can better understand their care plan, make informed choices, and prepare for their hospital stay.

Understanding Hospital Costs and Payments

The financial aspects of hospital admission can be complex and vary depending on the patient’s status and the type of hospital. How do costs differ between public and private healthcare?

Public Hospital Costs

In public hospitals:

• Public patients receive free hospital and medical services
• Some non-essential services may incur charges
• Medications prescribed during the stay are typically covered

Private Hospital Costs

For private patients or those in private hospitals:

• Costs may include accommodation, theatre fees, and specialist fees
• Health insurance can cover some or all of these expenses
• Out-of-pocket expenses may apply, depending on the level of insurance coverage

Can patients receive an estimate of their hospital costs before admission? Many hospitals provide cost estimates upon request. These estimates can help patients:

• Understand potential out-of-pocket expenses
• Check with their health insurance provider about coverage
• Plan for any necessary financial arrangements

Preparing for Your Hospital Stay: A Practical Guide

Proper preparation can significantly improve the hospital experience. What steps should patients take to prepare for a hospital admission?

1. Gather all necessary documents, including:
   • Identification
   • Insurance cards
   • List of current medications
   • Relevant medical records
2. Pack essential personal items:
   • Comfortable clothing and sleepwear
   • Toiletries
   • Any required mobility aids
   • Entertainment items (books, tablets, etc.)
3. Arrange for transportation to and from the hospital
4. Inform family members or friends about the admission
5. Make necessary arrangements for work, childcare, or pet care

How can patients ensure they have all the information they need before admission? Consider creating a checklist that includes:

• Contact information for your doctors and the hospital
• Details of your admission (date, time, location)
• Any pre-admission instructions (fasting, medication adjustments)
• Questions you want to ask your healthcare team

Patient Rights and Responsibilities in Hospital Settings

Understanding patient rights and responsibilities is crucial for a positive hospital experience. What are some key rights patients should be aware of?

• Right to informed consent for treatments and procedures
• Right to privacy and confidentiality of medical information
• Right to receive clear explanations about diagnosis and treatment options
• Right to refuse treatment, within legal and ethical boundaries
• Right to access medical records
• Right to be treated with respect and dignity

What responsibilities do patients have during their hospital stay? Patients are expected to:

• Provide accurate and complete information about their health history
• Follow treatment plans and hospital rules
• Respect the rights and privacy of other patients and staff
• Ask questions when they don’t understand something
• Inform healthcare providers of any changes in their condition

How can patients effectively communicate their needs and concerns to hospital staff? Consider these strategies:

1. Be clear and specific about symptoms or issues
2. Use the call button when assistance is needed
3. Keep a notebook to jot down questions as they arise
4. Request an interpreter if language barriers exist
5. Involve a trusted family member or friend as an advocate

By understanding their rights and responsibilities, patients can actively participate in their care and contribute to a more positive hospital experience.

Types of hospital admission – Better Health Channel

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Summary

Read the full fact sheet

• If you plan to go into hospital, it usually involves a doctor or specialist giving you a referral.
• Urgent (‘unplanned’) admission to hospital involves a sudden health issue that needs you to go to an emergency department or call an ambulance.
• When you get to a public hospital, you will be asked whether you would like to be a public patient or a private patient.
• Ask your doctor about your options so you can make the right choices.

It is good to have an understanding of the different ways you can be admitted to the Victorian hospital system so you can plan your hospital stay.

How you are admitted into hospital will vary depending on whether your visit is planned or unplanned.

Planned admission

If your hospital admission is planned, how you are admitted depends on whether you are going to a public or private hospital, what kind of treatment you are receiving and how urgent your treatment is.

Before going into hospital, your doctor will usually give you a referral to see a specialist, and you will need to contact the specialist clinic and make an appointment. The specialist will assess you and may send you for further tests to assess your health issue, before deciding what kind of treatment you require and whether you need to go into hospital for treatment or surgery. At this stage, you will also be told how long you will have to wait for treatment.

In public hospitals, your waiting time for planned surgery (also known as elective surgery) depends on how urgent your condition is, which is determined by the specialist who admits you to hospital. In a public hospital, you may not be able to choose your treating specialist.

In private hospitals, you will generally not have to wait as long for treatment and you can choose who your doctor is, but there are costs for this type of treatment.

Sometimes, even if you plan to go into a private hospital, the best place for your treatment may actually be in a public hospital. This is because the public hospital may have the best equipment, facilities and specialists for a particular health problem or treatment.

Once in hospital, you will stay in a hospital ward. How long you stay in hospital will depend on the treatment you need. For minor procedures, you may only need to stay for a day, but for ongoing treatment or major surgery, you will need to stay for longer.

Unplanned (urgent) admission

You may arrive at hospital in your own transport or in an ambulance. This is known as an ‘unplanned presentation’.

If your condition is unexpected and you need urgent treatment, you will be admitted through the emergency department on arrival at hospital – this is done through a process known as ‘triage’.

A specialist emergency nurse, called the triage nurse, will assess your condition, provide first aid and work out how quickly you need treatment.

You may be asked to wait in the waiting room. How long you have to wait depends on how busy the emergency department is at the time and whether there are other patients with more serious and urgent conditions than you.

Choosing to be a public or private patient

You may choose to be a public or private patient when you go into hospital.

If you are a public patient in a public hospital, there will be no cost for hospital or medical services. If you are a private patient in a public hospital, you or your health insurance company will have to pay for some services. Your health service should explain any costs involved in your care.

Read more about the difference between private and public healthcare costs in Hospital costs and payments.

Questions to ask before starting hospital treatment

It is important to ask your doctor the right questions about your medical treatment so you can make informed choices when the time comes to go into hospital.

When you are talking with your doctor, be sure to ask:

• Can I choose my specialist and if so, who will it be?
• Which hospital am I going to?
• How long am I likely to be there?
• What are my treatment options and the benefits and risks of each option?
• What are the likely consequences of not having treatment?
• How long am I likely to have to wait for my treatment?

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Content disclaimer

Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website.

Reviewed on: 02-06-2023

Hospital admission – what to expect

Going to hospital for surgery or treatment can be stressful, but knowing what happens when you arrive and understanding your hospital’s admission procedure can help you settle in.

Before you arrive at hospital

The letter, email or text message of admission (also called an ‘admission notice’) that your hospital sends to confirm the date and time of your hospital stay will also outline any special instructions you need to follow before arriving at hospital. For example, you may not be allowed to eat or drink anything for many hours before your treatment.

For planned hospital admissions, you may have to attend a pre-admission assessment to make sure you are ready for treatment. This may be done over the phone or you may need to come in for an appointment at the hospital.

You may also be asked to fill in an admission form with your personal and funding details, such as your Medicare card number and private health insurance details (if you have cover), and send this to the hospital several days before your admission.

Types of hospital admission

Depending on the purpose of your hospital stay, there are different types of hospital admissions, including:

• emergency (unplanned)
• overnight or extended (planned)
• maternity (planned)
• day procedure.

Emergency admission

Telephone triple zero (000) for medical emergencies. Even if you are not sure it is an emergency, still phone 000 as they will tell you what to do. In a medical emergency, you will be transported to hospital by ambulance. If the situation is urgent but not immediately life-threatening, you can be driven to the emergency department by private car. Emergency staff will let you know if you need to be admitted to hospital for further treatment.

As this kind of admission is unplanned, it may take some time for a hospital bed to be ready. Sometimes, the emergency staff may need to transfer you to another hospital for your treatment. Until then, you will be cared for in the emergency department.

Overnight or extended admission

For an overnight stay, or extended admission, your admission letter, email or text message should let you know where you need to go on the day of your admission to hospital. Bring this letter -and your pre-admission health questionnaire (if you have been asked to complete one) and go to the place stated in your admission letter, email or text message. You may receive a call from the hospital on the day before your admission to confirm your hospital stay.

When you get to the hospital, check in at the reception desk and show them your admission notification and Medicare card. There may be more paperwork to complete and you may have to pay up front for any out-of-pocket expenses (if you are a private patient). You will be shown to your hospital room or a waiting area by a nurse, who will then conduct an admission interview.

Maternity department admission

For a maternity admission, your maternity department will send or give you a patient information pack detailing what to do when your labour begins. This usually involves contacting the maternity department to let them know that your labour has started.

When you arrive at the hospital, make your way to the reception desk (if it is a maternity hospital) or go directly to the maternity department (if it is a general hospital) and let them know you have arrived. A midwife will assess you and if your labour has progressed enough or if complications have arisen, you will be admitted and taken to a birthing suite.

Day procedure admission

For a day procedure admission, bring your admission notification and your pre-admission health questionnaire (if you have been asked to complete one) and go to the place stated in your admission letter, email or text message.

On arrival, check in at the reception desk, where you may need to fill in more paperwork and pay for your out-of-pocket expenses (if you are a private patient). You will then be shown to the pre-operative area by a member of the nursing team, where they will conduct an admission interview.

Admission interview

During your admission interview, you will talk with a nurse about your medical condition and your current health status. The nurse may conduct some basic tests, such as taking your temperature and blood pressure, and will ask questions about your health to make sure you are ready for surgery or treatment.

If you are having surgery, an anaesthetist, who is the doctor responsible for anaesthetising you for the duration of your surgery or procedure, may also ask you questions. Your surgeon may visit you too.

Asking for an interpreter

For people who prefer to use a language other than English and for people who have vision, hearing or speech impairments, being unable to communicate effectively in hospital can be a serious situation.

All Victorian public hospitals provide free access to interpreting services (this includes Auslan for people with a hearing impairment). Professional, accredited interpreters are impartial and deliver a confidential service. Interpreters are usually available to come to the hospital or to interpret via telephone. You can request an interpreter to be with you during your admission interview and at any stage of your hospital stay.

You can also ask if the hospital can provide translated information in a written format.

Disability assistance and other special needs

If you have vision impairment, ask if the hospital provides information, pre-admission questionnaires and other forms in electronic, large print or Braille format. You can also ask if they can provide extra, adjustable lighting in your room.

A hospital staff member will help you get used to your room so that you know where your personal belongings are and where the bathroom is, as well as any obstacles.

If you have a hearing impairment, you can request an Auslan interpreter for all communication with hospital staff, including during an admission interview and at any stage of your hospital stay. You can also ask your hospital for a communication kit for people with a hearing impairment.

If you are in a wheelchair or have trouble moving, the hospital will have wheelchair ramps, accessible parking spaces and wheelchair-accessible lifts, toilets and rooms. Ask your hospital if they have an accessible writing desk where you can fill in forms during the admissions process.

Where to get help

• Your GP (doctor)
• Hospital administration staff
• Ward clerk (hospital receptionist)

Hospitalization

• Main page
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• About the procedure for providing medical care

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• Hospitalization

INFOGRAPHICS

Sometimes there are situations when the patient needs to be hospitalized. What is hospitalization, and in what cases is it applicable. Hospitalization is the placement of a patient in a hospital of a medical organization of private or state ownership. Depending on the method of delivery of the patient to the hospital and his condition, there are two main types of hospitalization of patients:

1. emergency hospitalization – a person is in an acute condition, which poses a serious threat to his health or life;

2. planned hospitalization – the term of admission to the hospital is agreed in advance with the doctor.

Ways of hospitalization of a citizen in a hospital facility:

1. ambulance: in case of accidents, injuries, acute diseases and exacerbation of chronic diseases;

2. in the direction of an outpatient clinic for planned hospitalization. Also, a referral can be issued by a medical and rehabilitation expert commission or a military registration and enlistment office;

3. hospitalization “by gravity” – with the patient’s independent treatment in the emergency department of the hospital in case of deterioration of his health;

4. transfer to another medical institution if specialized assistance is needed or the temporary closure of the medical organization where the patient was before.

Indications for hospitalization and timing

Emergency hospitalization.

Indications: acute diseases, exacerbations of chronic diseases, conditions requiring intensive care and round-the-clock medical supervision, other conditions that threaten the life and health of the patient or the life and health of others.

E emergency inpatient medical care is provided without delay – around the clock and without hindrance to anyone who needs it.
Hospitalization in a hospital for emergency indications is carried out at the direction of doctors of medical organizations of any form of ownership (including individual entrepreneurs engaged in medical activities), at the direction of paramedics-obstetricians, ambulance teams (medical, feldsher). CHI policy is not required in such cases
(Federal Law 326-FZ “On Compulsory Medical Insurance in the Russian Federation”). It is enough to go to the emergency department of the hospital or call an ambulance on your own.

Planned hospitalization – diagnostics and treatment requiring round-the-clock medical supervision. This type of treatment in a hospital is preceded by an examination by specialists, including the delivery of tests, x-rays, CT, MRI, etc.

Planned hospitalization is carried out within the time limits established by the territorial program of state guarantees for the provision of medical care, but not more than 30 days from the date the attending physician issues a referral for hospitalization
(with the exception of high-tech medical care, in the provision of which the terms may be exceeded).

In the direction of the clinic issued to the patient, the hospital doctor indicates the date of the planned hospitalization. Planned hospitalization is carried out if the patient has the following documents: a passport or other identity document, a valid compulsory medical insurance policy, a referral from a medical organization for primary health care, the results of diagnostic studies that can be carried out on an outpatient basis.

In the event of a planned hospitalization of a patient, the scope and timing of treatment and diagnostic measures are determined after the patient is examined by a doctor on the day of admission in accordance with the approved standards for the provision of medical care, patient management protocols, and the patient’s condition.

In case of violation of the terms of hospitalization

If it is impossible to comply with the stipulated waiting periods, the patient must be provided with the necessary medical care in other medical organizations operating in the CHI system.

If the deadlines are violated or if the patient does not know how long to wait, then, as advised by the Ministry of Health, you must immediately contact the employees of the medical insurance organization in which the patient is insured or the territorial CHI fund.

Hospital selection

For planned hospitalization . In case of a planned form of hospitalization, the choice of a medical organization is carried out in the direction of the attending physician . However, if several medical organizations providing medical care in the relevant profile take part in the implementation of the territorial program of state guarantees of free medical care for citizens, the treating the doctor is obliged to inform the patient about which hospitals operating in the CHI system provide the necessary medical care, and give a referral to the hospital that the patient has chosen (Federal Law-323 “On the Basics of Protecting the Health of Citizens in the Russian Federation”) .

For advice on choosing a hospital, the patient can also contact his insurance company. If the doctor does not want to discuss possible options and give a referral based on your choice, then the patient should contact the head of the department, the head physician of the polyclinic, or their insurance company.

In case of emergency hospitalization. The right to choose a hospital in the CHI system is valid not only for planned hospitalization, but only if it is not a threat to the patient’s life. In a life-threatening condition, the patient must be taken as soon as possible to the nearest hospital providing assistance of the required profile.

In all other cases, the patient has the right to choose. The patient has the right to ask a question about where he is planned to be hospitalized, to be reminded of his right to choose, and he must be offered a choice of at least two hospitals. However, ambulance and emergency stations serve certain areas of settlements. The ambulance doctor has the right to refuse to satisfy the patient’s demand for hospitalization in a hospital specifically named by the patient, located on the other side of the city, while there are several hospitals nearby that have departments of the necessary profile.

Scheduled hospitalization under compulsory health insurance

Scheduled hospitalization under compulsory medical insurance

Dear patients! We remind you that during a planned hospitalization in the GBUZ “City Clinical Clinical Hospital No. 17 DZM” you need to have data on a double immunization against measles, or past measles. (Order of the Department of Health of the city of Moscow dated March 30, 2018 218 “On improving measures to prevent the spread of measles infection)

In order to ensure the rights of citizens to receive free medical care, within the framework of the territorial program of state guarantees for the provision of free medical care to citizens, waiting periods are set. These terms cannot be longer than recommended by the Ministry of Health of the Russian Federation.

During planned hospitalization in a hospital, patients assigned to Moscow polyclinics who need qualified examination and inpatient treatment, are hospitalized in the presence of electronic referrals and extracts from medical records in electronic form directed exclusively through the EMIAS system ( from medical organizations connected to the EMIAS system).

On paper, referrals (recording form 057/у-04) and extracts from medical records (form No. 027-1/ or any medical documentation necessary for organizing hospitalization, examination, consultation) are accepted in the following cases:

• if it is not technically possible to receive documents in electronic form in the patient’s electronic medical record,
• for planned hospitalization of non-resident citizens with compulsory medical insurance policy under the Moscow Capital of Health program,
• when sent from departmental and federal medical organizations in Moscow that do not have access to the EMIAS system.

Comment
in accordance with the Order of the Moscow Department of Health of January 13, 2023 N 15 “On approval of the Regulations for routing patients for planned hospitalization, rehabilitation treatment, examination, consultation in medical organizations for receiving primary specialized health care and specialized, with the exception of high-tech, medical care”, in order to form a paperless workflow model for patients.

When registering for hospitalization, you must have:

Muscovite patients (when applying for CHI) must have:

• an electronic referral from the city polyclinic at the place of residence, sent through the EMIAS system;
• an extract from an outpatient card with the results of studies in electronic form in EMIAS;
• passport of a citizen of the Russian Federation;
• compulsory health insurance policy
• Patients from other cities (when applying for CHI) must have:
• direction issued under the Moscow Capital of Health program;
• extract from the outpatient card;
• passport of a citizen of the Russian Federation;
• compulsory health insurance policy

To apply for a free planned hospitalization, please contact the Call Center by phone: +7 (499) 638 30 17, email: [email protected]

An approximate list of tests and examinations required for planned hospitalization in a surgical hospital and their timing reality:

• Urinalysis (valid for 14 days)
• Complete blood count (valid for 14 days)
• Biochemical blood test (valid for 14 days)
• Blood glucose test (valid for 14 days)
• Blood test for group and Rh factor (on a laboratory form, not in the passport)
• Coagulogram (indicators of the blood coagulation system, valid for 14 days)
• Fluorography (valid for 6 months)
• ECG (valid for 1 month)
• Blood test for syphilis, HIV, hepatitis B, hepatitis C (valid for 3 months)
• Gynecological examination (women over 40, valid for 1 month)
• Endocrinologist’s consultation (in case of diabetes)
• Patients of a surgical hospital must have a conclusion of the therapist about the absence of contraindications for surgery
• Patients in a gynecological hospital need to have data from bacteriological examination of smears from the vagina, urethra and cervical canal, the results of cytological examination of smears of the cervix, ultrasound examination of the pelvic organs
• According to indications (doctor’s prescription): EGDS, ultrasound of the abdominal cavity.