This Owl Would Not Fly Environmental Factors Foil Attempt to Shift Unnecessary Inpatient Days to the Outpatient Setting

Abstract

The last days of many appropriate hospital admis sions have been identified as unnecessary when uti lized for providing diagnostic or therapeutic modali ties that could be provided in an outpatient setting. An outpatient work-up liaison team (OWL) was es tablished to facilitate the completion of evaluations or therapy in the community. In spite of the commit ment of experienced personnel and the cooperation of the staff physicians and hospital departments, the effort was unsuccessful. The failure is attributed to the socioeconomic environment in the immediate community that could not support the transfer of medical efforts. It is recommended that before any institution undertakes shifting hospital-based serv ices to the community a realistic assessment be made of the socioeconomic milieu.