Different Types Of Hospitalization And Hospital Admission

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What are Different Types of Hospitalization and Hospital Admissions? People are sent to the hospital for many reasons, not just for serious operations or treating life-threatening emergencies. There are several types of hospitalization and hospital admission for inpatient management. The most common are Elective Admissions, Direct Admissions, Holding Admissions, and Emergency Admissions. Depending on the needs, these admissions bring different levels of medical care.

Table of Contents

Learn About Different Healthcare Admissions and Hospitalizations

Elective Hospital Admissions

Elective hospital admissions make up most admissions, though how many depends on the hospital. These stays are when someone has a known medical condition or complaint that requires further treatment or surgery and hospital care, but patients can work with their doctor to alter the time of the admission for convenience. A doctor will make a hospital bed reservation for the patient on a specific day that can change as needed.

The doctor may tell the patient to go to the hospital in advance for lab tests, X-rays, ECGs, or other prescreening tests. For seniors aging at home or in a facility, as well as patients with mobility needs, an in-home hospital bed for resting before or after the elective date can make the experience much more comfortable.

Direct Admission Hospitalization

Direct admission would occur after the patient has seen or spoken to their doctor, who feels they must admit them to the hospital for immediate medical care. The doctor may arrange an ambulance to take the patient to the hospital or request that they go to the hospital themselves; the doctor may be able to make a bed reservation, too.

Holding Admission Hospital Stays

Holding or observation admission often takes place through the emergency department. The patient is admitted for diagnostic testing and, unless something shows up that requires another level of care, they will be discharged within 24 to 48 hours.

For example, if a senior loved one has chest pain that does not appear to be related to cardiovascular disease, but it’s not 100% in the doctor’s expert opinion, the patient may be admitted for further tests to ensure it wasn’t a cardiac episode. If the holding shows that they had a heart attack, the healthcare providers make it a full admission; if not, they would be discharged and sent to the doctor for further testing.

Emergency Admission Hospitalization

Finally, there are emergency admissions, which go through the hospital’s emergency department. A medical emergency is any serious injury, condition, or symptom posing an immediate risk to someone’s life or health. If they need emergency care, the hospital may admit the patient to a floor, a specialized unit, or an observation unit.

How Can I Prepare For Hospital Admission?

Seniors and their loved ones won’t always know when a hospital visit is necessary. What they can do is be prepared when it has to happen. Everyone should have the following information stored in a safe, central location in case of hospital admission.

• Identification like a driver’s license, medical card, emergency contacts (relatives and friends names and phone numbers), and name(s) of the primary care physician and the specialists that treat the patient.
• A list of all current medications – including strength and frequency – as well as any treatments or over-the-counter medications. Never lie about what you are taking.
• Necessary medications. Keep them in a carrying case or have one handy for quick packing.
• A list of all allergies, including the reaction the patient has to them.
• A list of all medical conditions and all past surgeries or procedures (not just the most recent).
• Make sure to fill out a living will and appoint a medical power of attorney. This way, your wishes about end-of-life medical treatment are documented if you cannot speak for yourself.

If you or a loved one are in the hospital for an elective admission, you have more time to prepare. Another loved one can also supply them should an emergency or holding admission be necessary. 

• Important personal items like smartphones, chargers, batteries, eyeglasses, mobility equipment, and hearing aids.
• Toiletries, like soap, shampoo, a toothbrush, toothpaste, deodorant, and a hairbrush. The hospital will likely have basic supplies, but many patients do not like them.
• Moisturizer and lip balm. Hospitals can be very drying, making the patients uncomfortable.
• Clean underwear, socks, and pajamas.

Being admitted to the hospital for care and recovery can be stressful; the problem can be more difficult if a patient has Alzheimer’s disease or dementia. An in-home hospital bed and other assistive equipment may help patients reduce the amount of time they need to spend in a medical facility and help them get back to familiar surroundings sooner.

Frequently Asked Questions About Types Of Hospitalization

What are the three ways of a patient’s admission to a hospital?

Entrance into the hospital on an elective basis to treat or diagnose a specific medical condition. The emergency department also admits patients on an emergency basis. Same-day surgery is another common admission type.

When admitting a patient what are the basic procedures?

The first step in admission is securing a physician admitting orders sheet/doctor’s order or admission notice slip from the emergency department. As a second step, secure permission for admission and gather data before verifying completed forms for completeness and accuracy. As a final step, confirm room preferences and coordinate with nursing staff.

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Direct admission to hospital: an alternative approach to hospitalization

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• PMC4821712

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J Hosp Med. Author manuscript; available in PMC 2017 Apr 1.

Published in final edited form as:

J Hosp Med. 2016 Apr; 11(4): 303–305.

Published online 2015 Nov 20. doi: 10.1002/jhm.2512

PMCID: PMC4821712

NIHMSID: NIHMS734557

PMID: 26588666

, MD, MPH, MSc,¹, MD, MPH,^2,3 and , MD, MSc^2,3

Author information Copyright and License information Disclaimer

Appropriate use of emergency departments (ED) is a focus of national healthcare reform efforts, and patients requiring hospital admission account for a substantial proportion of ED utilization. Despite this, little attention has been paid to evaluating direct admission to hospital as an alternative to hospital admissions beginning in the ED. In this Perspective, we discuss the role of hospital medicine in the changing epidemiology of hospital admissions, the potential risks and benefits of direct admission to hospital, and the need for research to evaluate the safety and effectiveness of this admission approach. We propose that transitions of care research and quality improvement, historically focused on hospital-to-home transitions, be expanded to address transitions into the hospital.

Keywords: hospital admission, transitions of care, direct admission, patient-centered outcomes

Increasing use of emergency departments (EDs) throughout the United States has become a focus of national healthcare policy and reform efforts. ED growth continues to outpace population growth, with the Institute of Medicine describing our ED systems as fragmented, overburdened, and at the breaking point.¹ Associations between ED crowding and patient dissatisfaction, delays in treatment, medical errors and patient mortality speak to the urgency of systems improvements. ² One major factor contributing to ED volumes is the growing number of hospital admissions that begin in EDs – from 1993 to 2006, the proportion of hospitalizations originating in EDs increased from 33.5% to 43.8%, with more than 17 million hospital admissions originating in EDs annually.^3,4 Despite these challenges, discussions about alternative approaches to hospital admission remain at the periphery of healthcare policy conversations.

Direct admission to hospital, defined as hospitalization without first receiving care in the hospital’s ED, is an alternative approach to hospital admission, and may be a vehicle to both observation and inpatient hospital stays. Direct admissions account for 25% of all non-elective pediatric hospitalizations and 15% of non-elective adult hospitalizations in the United States.^5,6 This admission approach was considerably more common in the past, facilitated by primary care providers (PCPs) or specialists who provided both outpatient and hospital-based care for their patients. ⁴ However, as the number of hospitalists in the United States has grown over the last 30 years, the number of direct admissions has decreased concurrently. In fact, from 2003 to 2009, the number of direct admissions from clinics and physicians’ offices decreased by a total of 1.6 million.⁴ Although this decline is undoubtedly multifactorial, hospitalists may have contributed, both deliberately and inadvertently, to the shifting epidemiology of hospital admissions. While many factors influence the source of hospital admissions and admission processes, direct admission has two important prerequisites: patients require timely access to outpatient providers for acute care, and hospitals, in partnership with outpatient-based clinics and practices, require systems to safely and efficiently facilitate admissions without ED involvement. However, we know little about hospital admission systems, developed in the era of hospital medicine, to facilitate admissions independent of the ED.

Direct admission offers a number of potential benefits for both patients and healthcare delivery systems including reductions in the number of sites and providers of care, improved communication and coordination between outpatient and hospital-based healthcare providers, greater patient and referring physician satisfaction, and reduced ED volumes and subsequent costs.⁷ However, there are also risks and potential harms associated with direct admission, including potential delays in initial evaluation and management, inconsistent admission processes, and difficulties determining direct admission appropriateness, all of which could adversely impact patient safety and quality of care.^7-9 One study of adults with sepsis found that direct admission was associated with increased mortality compared to ED admission, which the authors speculated to be related to less timely care.⁹ Similarly, a study of unscheduled adult hospitalizations found that patients admitted directly had higher mortality for time-sensitive conditions such as acute myocardial infarction and sepsis than patients admitted through EDs, differences not observed among adults admitted with pneumonia, asthma, cellulitis and several other common, yet frequently less emergent, reasons for hospitalization. ⁸ Among children with pneumonia, the most common reason for pediatric hospitalization, direct admission has been associated with significantly lower costs than admissions originating in the ED, with no significant differences in rates of transfer to the intensive care unit or hospital readmission.¹⁰

There is significant variation across both diagnoses and hospitals in rates of direct admission, raising questions about the contextual factors unique to hospital medicine programs that perform a substantial proportion of direct admissions.⁵ This variation also highlights opportunities to identify the populations, conditions, and systems that facilitate safe and effective direct admissions. Certainly, direct admission is unlikely to be appropriate for all populations or conditions. Patients requiring emergent care or rapid diagnostic imaging are likely to receive more timely care in the ED; sepsis, AMI and trauma are but a few examples of conditions for which rapid ED care decreases morbidity and mortality. Similarly, patients for whom the need for hospitalization is uncertain – for example, dehydration, asthma – may be more appropriate for initial ED management followed by re-evaluation to inform the need for hospitalization. Finally, patients for whom the admitting diagnosis is uncertain and who require consultation for several subspecialists may be more efficiently evaluated in EDs. In our national survey of pediatric direct admission guidelines, less than one-third of hospitals reported having formal criteria to assess the appropriateness of direct admissions, and respondents’ perspectives regarding populations and diagnoses appropriate for this admission approach varied considerably.⁷ These results point to the need for further research and quality improvement initiatives to inform the development of direct admission guidelines and protocols.

During the last decade, hospitals’ discharge processes have been the focus of tremendous research, policy, and quality improvement efforts. The phrase “transition of care” is now widely understood to describe the changes in patient care that begin with discharge planning, and conclude when patients’ have established care at home or another healthcare facility. Transitions of care have been a focus of the Journal of Hospital Medicine since its inception, including publication of the Transitions of Care Consensus Policy Statement in 2009, as well as numerous other studies highlighting both risks associated with transitions of care as well as methods to address these.^11-16 Similar to hospital discharge, hospital admission is an inherent feature of every hospitalization, and admission and discharge processes share many commonalities. Both involve transitions in sites of care, and handoffs between healthcare providers. Most involve changes in medical therapies, including both the addition of new medications and changes to existing treatments. And both are associated with significant stress to patients and their families. As a result, hospital admissions expose patients to many of same risks that have been the focus of hospital discharge reform: unstructured patient hand-offs, poor communication between healthcare providers, and costly, inefficient care. The Society of Hospital Medicine has been a leader in articulating the importance of patient-centered, clinically relevant medication reconciliation across the health care continuum.¹⁷ However, with the exception of this important work, research and policy focused on understanding and improving transitions of care into the hospital have received disproportionately little attention.

To facilitate research and quality improvement efforts focused on hospital admission, we suggest that the transitions of care framework, typically discussed in the context of hospital discharge, be expanded to reflect the different origins of hospitalizations and multiple transitions that can be experienced by patients as they enter the hospital. A broadening of the transitions of care framework to incorporate hospital admissions brings numerous questions previously addressed in hospital-to-home transitions to the forefront. How do transitions into hospital impact patients and healthcare systems? When is direct admission safe and effective, and how does this vary across conditions and hospital settings? What protocols and tools might optimize the associated transitions and reduce the risks of error and harm? There are numerous stakeholders who will undoubtedly bring diverse perspectives to these questions – patients and their families, hospital-based healthcare providers, PCPs and specialists, ED physicians and payors.

Increasing ED volumes, long wait times, and rising ED costs speak to the importance of better understanding hospital admission alternatives and the associated risks and benefits. Encouraging more direct admissions may be a solution, but evidence to guide best practices must precede this. The growing presence of round-the-clock pediatric and adult hospitalists across the country creates unique opportunities to transform hospital admission systems for the vast number of patients who do not require emergent care. The Affordable Care Act’s expansion of insurance coverage and incentivized coordinated care within patient-centered medical homes creates a unique opportunity for this broadened view of transitions of care. This suggests that the time is ripe for pursuing strategies that will both improve patients’ transitions from outpatient to inpatient care and reduce stress on our overburdened emergency departments.

Funding/ Support: Dr. Lagu was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Number K01HL114745. She has received consulting fees from the Institute for Healthcare Improvement, under contract to CMS, for her work on a project to help health systems achieve disability competence, and from The Island Peer Review Organization, under contract to CMS, for her work on development of episodes of care care for CMS payment purposes . (both unrelated to current work). Dr. Leyenaar was supported by grant number K08HS024133 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.

Conflict of Interest Disclosures: The authors have no conflicts of interest.

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State budgetary institution of health care of the Samara region “Samara city hospital No. 7”

State budgetary institution of health care of the Samara region “Samara city hospital No. 7″

Address: 443112, p. 17

How to get there: travel is carried out by bus routes 50, 1, 210, 221, 79, 78, 45, 232, 389, 392 to the stop “Seventh quarter”.

e-mail: [email protected]

Head doctor’s office phone: 975-32-38

Reception department phone: 975-32-32

Head physician Dubasova Anna Anatolievna	975-32-57
Head doctor’s office	975-32-38
Deputy Chief Medical Officer Tyurin Mikhail Nikolaevich	975-32-00
Deputy Chief Physician for Economic Affairs Alexander Sutyagin	975-32-62
Head of the economic department Mezhenin Vasily Vasilyevich	975-32-52
Deputy Chief Medical Officer for civil defense and mob. work Elizarov Alexander Vasilyevich	975-32-40
Deputy chief physician for examination of temporary disability Afanasyeva Svetlana Vyacheslavovna	950-15-18
Chief Accountant Khusnudinova Madinya Damirovna	975-31-88
Legal Department	975-31-86
Extrabudgetary Department Kosareva Natalia Vladimirovna	975-31-84
Head of the “Health Center” with the prevention department Leushina Margarita Sergeevna	8 960 823 09 08
Head of the automated control system department, chief power engineer Inyutin Konstantin Viktorovich	975-32-51
Personnel Department Andreeva Svetlana Andreevna	975-32-42
Bashkova Valentina Borisovna	975-31-85
Hospital departments
Reception department of the hospital Head of the department: Bordachev Artyom Nikolaevich	975-32-32
Office of Emergency Traumatology and Orthopedics Head of Department: Sazonov Alexander Aleksandrovich	975-32-35
Department of Traumatology and Orthopedics Head of Department: Sidorov Igor Vladimirovich
Therapeutic department Head of department: Imaeva Irina Pavlovna	975-32-58 (ext. 1), 975-32-10 (ext. 2 or 3)
Department of Gynecology Head of Department: Morozov Valery Evgenievich	975-32-06
Surgery department Head of Department: Rodin Oleg Dmitrievich	975-32-15
Department of Anesthesiology and Intensive Care Head of Department: Lukaev Rinat Rifatovich	975-32-21
Department of Palliative Care I.O. Head of the department: Tyurin Mikhail Nikolaevich	950-27-60
X-ray department Head of department: Rychkova Olga Evgenievna –	975-32-50
Outpatient Department No. 1. 443112, Administrative settlement, st. Simferopolskaya, 4
Head of APO No. 1 Polyakova Anna Alexandrovna	950-62-44
Reference	950-22-22 975-30-11
Call center for making an appointment	307-77-17
Emergency	950-49-92
Head of Therapeutic Department Kvasov Viktor Alekseevich	950-43-06
Pharmacy manager Bogoslovskaya Tatyana Vladimirovna	950-46-92
Senior Nurse Grishina Natalya Vladimirovna	950-14-92
Dermatovenereologist Kondurtsev Alexey Valerievich	950-55-06
Occupational pathologist Evdokimova Elena Alexandrovna	950-64-66
Head of the Dental Department Komleva Irina Anatolyevna
Children’s department APO No. 1
Head of Department Akhmerova Lyubov Grigorievna	975-36-84
Information desk of the children’s department	975-36-91
Women’s consultation APO №1
Head of Department Kosyreva Vera Alekseevna	975 36 88
antenatal clinic	975-36-90
Outpatient Department No. 2. 443028, pos. Mekhzavod, quarter 3, building 9
Head of APO No. 2 Fokina Olga Alekseevna	975-34-60
Reference	975-34-56
Call center for making an appointment	307-77-17
Information desk of the children’s department	975-30-10
Information desk of the dental department	957-02-47
Head of Therapeutic Department Belyaeva Natalya Vladimirovna	957-20-29
Head of the children’s department Darya Mikhailovna Larina	957-02-15
Outpatient department No. 3. 443048, pos. Krasnaya Glinka, st. South, 1
Head of APO No. 3 Laukhina Natalya Viktorovna	978-24-30
Reference	978-22-02
Call center for making an appointment	307-77-17
Information desk of the children’s department	957-02-05
Head of the Therapeutic Department Slepneva Svetlana Aleksandrovna	978-24-94
Outpatient department No. 4. 443902, pos. Coastal, st. Sailing, 10
Head of APO No. 4 Kuzovkova Svetlana Viktorovna	977-30-93
Reference	977-62-22
Head of women’s consultation Pshenichnikova Nadezhda Vasilievna	977-30-94
Pediatric department Loginov Vladimir Alexandrovich	977-46-06
Outpatient Department No. 5. 443901, pos. Bereza, quarter 2, building 11
Head of APO No. 5 Uzenkova Svetlana Mikhailovna	996-43-72
Reference	996-55-96

State Budgetary Health Institution of the Samara Region “Samara City Hospital No. 7”

Posted on Wed, 05/17/2023 – 11:32 by zenno

Due to the change in technical conditions in APO No. 1 (Upravlenchesky settlement, Simferopolskaya St.), the phone number of the registry has changed!

New number: 975-30-11!

Request to everyone who has an old number recorded, change it! Please be understanding!

Published on Tue, 04/05/2022 – 10:45 by zenno

In accordance with the order of the head physician of the Samara City Hospital No. 7 A.A. Dubasova No. 592 from 12/20/2022 on the basis of the letter of the Ministry of Health of the SO dated December 16, 2022 No. MZ / 4209-vn, the Decree of the Chief State Sanitary Doctor of the Rospotrebnadzor Administration for the Samara Region dated September 24, 2021 No. 6-P “On the introduction of restrictive measures during the epidemic rise in the incidence of acute respiratory viral infections and influenza in the Samara region” visits to patients undergoing inpatient treatment are PROHIBITED!

Posted on Thu, 06/03/2021 – 10:09 by zenno

0028 – Reception department: 975-32-32
– Emergency room – 975-32-35

Posted on Thu, 06/08/2023 – 15:31 by zenno

Russian insurance.
You can find out:
– What is a digital MHI policy, how does it look like?
– How and where can I get a digital policy
– Do I need to change a paper policy
– What documents to present when applying for medical care
– Where to go if you cannot apply for a policy yourself

Posted on Thu, 06/08/2023 – 15:30 by zenno

diseases.
Save your health!

Posted on Wed, 05/24/2023 – 12:24 by zenno

Regular preventive check-ups and medical check-ups help keep you healthy. Coverage of the population with preventive medical examinations and medical examinations is one of the key areas of the national project “Healthcare”, initiated by the President of the country Vladimir Putin.