The Health Service Executive (HSE) has launched an extensive audit of the appropriateness of admissions to hospitals across the State through accident and emergency departments.
It is understood that a large group of nurses have been trained to assist with the exercise which is being undertaken in conjunction with an outside firm of consultants, PA Consulting.
The process began in recent days at the five hospitals in the northeast region where the charts of several patients admitted as emergencies on a given date were selected at random and examined.
The patients will be followed through at a later date and experts are expected to advise on whether the patients were treated appropriately and whether they should have been admitted in the first place. Their length of stay will also be studied.
The exercise is part of an overall review of how beds are used in acute hospitals to determine whether they are used appropriately.
Asked about the exercise yesterday, the HSE confirmed in a statement it was undertaking "a national review of inpatient hospital utilisation". It was being undertaken in all 38 acute hospitals that had an A&E department, it said.
The purpose of the study, it said, was to examine the use of inpatient services by patients to determine issues such as whether most patients required admission, to see if the patients actually needed to receive most of their care in the inpatient setting or to what extent care could be provided in another way.
"It is acknowledged that if other levels of care were available to a greater extent that some patients may not actually require to be admitted or to spend as long in hospital," the statement said.
"This study will examine to what extent this may be the case and it will estimate the types of alternative care that could be made available to a greater degree to relieve services from the acute inpatient setting."
The survey is being carried out in each hospital network, one by one, and is expected to be completed by next March when results will be made available to each hospital. "This survey team is made up of specialists in public health medicine and nursing staff who have received specific training to carry this survey out," the HSE said.
But the Irish Hospital Consultants Association (IHCA) has expressed concern about how the review is being carried out. Finbar Fitzpatrick, its secretary general, said last night it appeared this was a paper review only and that there was no plan to speak to the consultants who admitted the patients to find out why they admitted them. "We find that a serious short- coming in the audit," he said. "It's very easy with the gift of hindsight to decide whether an admission was appropriate as an emergency or not . . . doctors are obliged to err on the side of caution."
He said representations were being made to the HSE regarding the review and the IHCA wanted to ensure that if clinical decisions were being reviewed, they would be reviewed by independent outside clinicians rather than by "non-doctors".
The HSE said this type of study had not been undertaken in the State before. "Results will be made available to each hospital. They will also be analysed by network and nationally," it said.
Chief executive of the HSE, Prof Brendan Drumm, has already expressed the view that the State is "massively equipped with hospital beds" and the focus needs to be on treating people in the community rather than in hospital beds.