Helge Garåsen The Trondheim Model - NSDM

general hospital care. One of the conclusions from this group was to establish an intermediate
care department at a nursing home. The expert group concluded (unpublished report) that:
- During the last ten years an increasing proportion of older patients have been referred
to the city general hospital.
- Older people often wait in long queues for: elective general hospitalising,
appointments at outpatient departments, general practitioners, home care,
rehabilitation units and nursing homes.
- There is a huge and increasing gap in technical equipment used and qualifications to
be found at the general hospital and in primary care.
- There exist no care options between traditional general hospital and primary health
care where older patients can get both “cure and care” with specially qualified health
personals at an intermediate level.
- There is probably “a missing link in the chain of care”.
Administrators at the general hospital and in the municipality decided, in autumn 2001, to
establish a community hospital with 20 beds (39) to provide intermediate level care (47-48).
The community hospital would provide intermediate level care for older patients initially
admitted to the city general hospital, but who have no need for further advanced general
hospital care. The aim was to create a department that could function as a new link between
general hospital care and community home care to optimise recovery before the patients
returned home (39). The main hypothesis was that intermediate care at a community hospital
(an upgraded nursing home department/ward) compared to traditional prolonged care at a
general hospital would reduce morbidity as well as the need for home care and long-term
nursing home care.
3.0 Objectives and hypothesis
3.1 The main objectives of the thesis
1. To evaluate the quality of referral and discharge letters between physicians for patients
referred to cardiologic, orthopaedic and pulmonary departments at St. Olavs University
Hospital.
2. Through an evaluation of referral and discharge letters:
35