How does hospital admission work. What are the types of hospital admissions. How to choose between public and private patient status. What questions should you ask before hospital treatment. How does triage work in emergency departments.

Types of Hospital Admissions: Planned vs. Unplanned

Hospital admissions generally fall into two main categories: planned and unplanned. Understanding the difference between these types can help patients navigate the healthcare system more effectively and prepare for their hospital stay.

Planned Admissions

A planned admission, also known as an elective admission, occurs when a patient’s hospital stay is scheduled in advance. This type of admission is typically for non-emergency procedures or treatments that have been recommended by a healthcare provider.

• Usually initiated by a referral from a primary care physician or specialist
• Allows time for pre-admission testing and preparation
• May involve waiting periods, especially in public hospitals
• Gives patients the opportunity to choose their hospital and, in some cases, their specialist

Unplanned Admissions

Unplanned or urgent admissions occur when a patient requires immediate medical attention due to a sudden illness, injury, or worsening of an existing condition.

• Often involves arrival through the emergency department
• May require ambulance transport
• Utilizes a triage system to prioritize patient care based on severity
• Does not allow for advanced planning or choice of specialist

The Hospital Admission Process: From Referral to Treatment

The journey from initial medical concern to hospital treatment involves several steps, particularly for planned admissions. Understanding this process can help patients feel more prepared and informed about their healthcare journey.

1. Initial consultation with a primary care physician
2. Referral to a specialist for further evaluation
3. Specialist assessment and diagnostic tests
4. Treatment recommendation and admission planning
5. Pre-admission testing and preparation
6. Hospital admission and treatment
7. Post-treatment care and discharge planning

For unplanned admissions, the process begins at step 5 or 6, depending on the urgency of the situation and the patient’s condition upon arrival at the hospital.

Public vs. Private Patient Status: Making an Informed Choice

When admitted to a public hospital, patients in many healthcare systems have the option to choose between public and private patient status. This decision can have significant implications for the cost of care, waiting times, and choice of healthcare providers.

Public Patient Status

Choosing public patient status in a public hospital typically means:

• No out-of-pocket costs for hospital or medical services
• Treatment by hospital-appointed doctors
• Longer waiting times for non-urgent procedures
• Limited choice in selecting specialists or scheduling treatment dates

Private Patient Status

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

• Out-of-pocket expenses or claims through private health insurance
• Ability to choose your treating specialist
• Potentially shorter waiting times for elective procedures
• More flexibility in scheduling treatment dates

Is private patient status always the better choice? Not necessarily. The decision should be based on individual circumstances, including financial considerations, health insurance coverage, and personal preferences. Patients should discuss their options with their healthcare provider and insurance company to make an informed decision.

Emergency Department Triage: Prioritizing Patient Care

Triage is a critical process in emergency departments that ensures patients receive care based on the severity and urgency of their condition rather than their order of arrival. Understanding how triage works can help patients manage their expectations during an emergency visit.

The Triage Process

1. Initial assessment by a triage nurse upon arrival
2. Assignment of a triage category based on urgency
3. Prioritization of care according to triage category
4. Ongoing reassessment of waiting patients

How long might you wait in an emergency department? Wait times can vary significantly based on the triage category assigned and the overall volume of patients. While it can be frustrating to wait, remember that a longer wait time often means your condition is less urgent compared to other patients requiring immediate care.

Essential Questions to Ask Before Hospital Treatment

Being well-informed about your hospital treatment can significantly improve your experience and outcomes. Here are some crucial questions to ask your healthcare provider before starting treatment:

• What are my treatment options, and what are the pros and cons of each?
• What are the potential risks and side effects of the recommended treatment?
• How long is the expected hospital stay?
• What is the anticipated recovery time?
• Are there any alternatives to hospitalization?
• What preparations should I make before admission?
• What items should I bring to the hospital?

Why is it important to ask these questions? Being proactive in your healthcare journey can lead to better preparedness, reduced anxiety, and potentially improved outcomes. Don’t hesitate to write down your questions and bring them to your appointments.

Navigating Hospital Costs and Insurance Coverage

Understanding the financial aspects of hospital admission is crucial for avoiding unexpected bills and making informed decisions about your healthcare. The costs associated with hospital stays can vary widely depending on factors such as the type of admission, length of stay, and chosen patient status.

Public Hospital Costs

In many countries with public healthcare systems, treatment in public hospitals is often free or heavily subsidized for citizens and permanent residents. However, it’s important to note that:

• Some services may still incur out-of-pocket expenses
• Non-residents may be charged full fees
• Choosing private patient status in a public hospital can lead to additional costs

Private Hospital Costs

Private hospital admissions typically involve more significant costs, which may be covered partially or fully by private health insurance. Patients should consider:

• Hospital accommodation fees
• Surgeon and anesthetist fees
• Diagnostic tests and imaging costs
• Medication expenses
• Potential gap payments not covered by insurance

How can patients manage hospital costs effectively? Consider these strategies:

1. Review your health insurance policy to understand coverage and limits
2. Request detailed cost estimates from the hospital and healthcare providers
3. Inquire about payment plans or financial assistance programs
4. Consider the trade-offs between public and private treatment options

Preparing for Your Hospital Stay: A Comprehensive Checklist

Proper preparation can significantly enhance your hospital experience and potentially contribute to a smoother recovery. Here’s a comprehensive checklist to help you prepare for your hospital admission:

Medical Preparations

• Complete all pre-admission tests as requested
• Prepare a list of current medications, including dosages
• Gather relevant medical records and imaging results
• Inform your doctor of any allergies or previous adverse reactions

Personal Items

• Comfortable clothing and sleepwear
• Toiletries and personal hygiene items
• Eyeglasses, hearing aids, or other necessary devices
• A small amount of cash for incidentals
• Entertainment items such as books, magazines, or electronic devices

Administrative Preparations

• Insurance cards and identification documents
• Advance directives or living will, if applicable
• Contact information for your primary care physician
• List of emergency contacts

What should you avoid bringing to the hospital? It’s best to leave valuable items, large sums of money, and unnecessary electronics at home. Hospitals typically cannot be held responsible for lost or stolen personal belongings.

Understanding Hospital Discharge Planning and Follow-up Care

Discharge planning is a crucial aspect of hospital care that begins soon after admission and continues throughout your stay. Effective discharge planning ensures a smooth transition from hospital to home or another care facility and can significantly reduce the likelihood of readmission.

Key Components of Discharge Planning

1. Assessment of post-hospital needs
2. Development of a comprehensive care plan
3. Medication reconciliation and education
4. Arrangement of necessary home health services or equipment
5. Coordination with community resources and support services
6. Scheduling of follow-up appointments

How can patients actively participate in their discharge planning? Consider these strategies:

• Ask questions about your recovery and ongoing care needs
• Ensure you understand all discharge instructions
• Review medication lists and schedules carefully
• Discuss any concerns about managing your care at home
• Identify a family member or friend who can assist with your transition

Follow-up Care

Follow-up care is essential for monitoring your recovery and addressing any post-discharge issues. This may include:

• Appointments with your primary care physician or specialists
• Home health visits for wound care, therapy, or monitoring
• Outpatient rehabilitation services
• Ongoing diagnostic tests or imaging

Why is adherence to follow-up care important? Consistent follow-up can help identify and address complications early, ensure proper healing, and support a full recovery. It’s crucial to attend all scheduled appointments and communicate any concerns or changes in your condition to your healthcare providers.

Patient Rights and Responsibilities in Hospital Settings

Understanding your rights and responsibilities as a hospital patient is crucial for ensuring quality care and a positive healthcare experience. While specific rights may vary depending on location and healthcare system, there are generally accepted principles that guide patient care in hospital settings.

Common Patient Rights

• Right to informed consent for treatments and procedures
• Right to privacy and confidentiality of medical information
• Right to receive respectful and non-discriminatory care
• Right to access your medical records
• Right to refuse treatment (within legal and ethical boundaries)
• Right to receive information about your diagnosis, treatment options, and prognosis
• Right to involve family members or advocates in your care decisions

Patient Responsibilities

Along with rights come certain responsibilities that patients are expected to fulfill:

• Providing accurate and complete medical history
• Following treatment plans and instructions
• Asking questions when information is unclear
• Treating healthcare providers and other patients with respect
• Adhering to hospital rules and regulations
• Providing accurate insurance and payment information

How can patients effectively advocate for their rights? Consider these strategies:

1. Familiarize yourself with the hospital’s patient rights and responsibilities policy
2. Communicate openly and honestly with your healthcare team
3. Keep a record of your care, including medications, treatments, and discussions with providers
4. Don’t hesitate to speak up if you have concerns or feel your rights are not being respected
5. Utilize patient advocacy services if available

Understanding and exercising your rights as a patient can lead to better communication with your healthcare team, improved care outcomes, and a more satisfactory hospital experience overall.

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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• Main page
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• Useful information
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• About the procedure for providing medical care

9 0003 /

• 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.