The King's Fund has produced ground-breaking models (PARR and the Combined Predictive Model) that help primary care trusts (PCTs) predict the risk of emergency re-admission and first-time admission to hospital by identifying patients who are at risk of, but who have not yet entered, a spiral of emergency admissions.

The models have in a short time enabled PCTs to reduce emergency re-admission rates and save costs in hospitals across the country.

Our products

We have developed two products, both of which are free to download from this site:

• The Patients at Risk of Re-hospitalisation (PARR) tool, a software tool with an easy-to-use interface that uses routine inpatient data to identify patients most at risk of future emergency re-admission to hospital. A new improved version of the tool, PARR++, will be launched in November 2007, and can be pre-ordered from this website.
• The Combined Predictive Model, which links inpatient, outpatient, accident & emergency and GP data to identify the likelihood of patients across a whole PCT population being admitted to hospital. Unlike the PARR model, the Combined Predictive Model does not have a user interface and is a ‘string’ of code that would need to be built by a programmer.

Why were these products developed?

This work was commissioned by the Department of Health and Strategic Health Authorities and developed by the King's Fund in partnership with New York University and Health Dialog to enable better management of patients with long-term conditions.

Such conditions mean significant morbidity and cost, and previous work by the King's Fund had shown that many emergency admissions are of patients with conditions such as asthma, diabetes, chronic obstructive pulmonary disease, epilepsy, cellulitis and sickle cell disease. More effective primary care can reduce the risk of such patients being admitted.

PCTs face the ongoing challenge of allocating patients to appropriate 'at risk' groups – as set out by Department of Health guidelines – and specifically to identify the patients who would benefit most from intensive case management. PARR accurately identifes high-risk individuals, whereas the Combined Predictive Model stratifies the whole PCT population according to their risk of admission. These two products help PCTs to intervene and reduce future hospital admissions.

• PARR case finding tool
• Combined predictive model
• King's Fund work on managing long-term conditions