Clinical decision-making could be cause of high admission rates at Letterkenny University Hospital

Letterkenny General Hospital
The HSE National Director for Acute Hospitals has suggested that admission rates to Letterkenny University Hospital are higher than other hospitals due to a difficulty to attract and retain senior clinicians.
40 percent of patients who visit the Emergency Department in Letterkenny are admitted to the hospital, 14% higher than the national rate.
Liam Woods, the HSE National Director for Acute Hospitals has said that clinical decision-making is a factor behind major variations in hospitals’ admission patterns.
He told a seminar in Dublin that Letterkenny University Hospital has a propensity to admit 40 per cent of patients from the ED compared with a rate of 27 per cent nationally.
He noted that the admissions rate varied widely: from as low as 9 per cent for children to between 55-60 per cent for those aged over 85.
In part, Woods said the reasons were geographic, but clinical decision making was also a factor. He said in Letterkenny, where patients were potentially more likely to be admitted, the hinterland population was distributed across remote areas and patients were likely to have seen their GPs before attending hospital.
But it may also be the case that in a hospital such as Letterkenny, that struggles to attract and retain senior clinicians, Mr Woods said there may be a higher degree of caution among junior clinicians thus a “higher propensity to admit patients”.
Mr Woods told the seminar that Letterkenny opened 10 additional beds over the recent winter to support the hospital’s emergency department and that had reduced the number of patients waiting on trolleys for admitance.