Table 2:

Factors associated with potentially avoidable admissions

FactorPotentially avoidable admissions, no (%)*
n = 67
Health system
Government directive of 4-hour limit for admission decision-making28 (42)
Subspecialist request to admit22 (33)
Overcrowding in the ED13 (19)
Lack of available services to determine suitability of safe discharge10 (15)
Poor access to urgent outpatient investigations10 (15)
Unavailable specialist or ancillary care8 (11)
Lack of timely access to community-based resources4 (6)
Diagnostic and therapeutic uncertainty38 (57)
Perceived need for short-term patient monitoring32 (47)
High number of consults during shift, admitted to increase efficiency with workload12 (18)
Resident–faculty culture (admitting to avoid overnight call to staff physician)4 (6)
Uncertainty regarding patient preference2 (3)
Patient and family
Frailty (physical or cognitive)16 (24)
Health literacy: language barrier10 (15)
Socially isolated; lack of social support; unsafe to discharge without access to caregivers4 (6)
Lack of access to housing/transportation home1 (1)
Mental illness or substance use; concern re: risk of harm1 (1)
  • Note: ED = emergency department.

  • ↵* More than 1 factor may have been selected for each avoidable admission.