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Evidence and consultations

Emergency hospital admissions for ambulatory care-sensitive conditions

Identifying the potential for reductions

Authors

Ambulatory care-sensitive conditions (ACSCs) are conditions for which effective management and treatment should limit emergency admission to hospital. Nevertheless, ACSCs currently account for more than one in six emergency hospital admissions in England. These emergency admissions cost the NHS £1.42 billion each year.

High levels of admissions for ACSCs often indicate poor co-ordination between the different elements of the health care system, in particular between primary and secondary care. An emergency admission for an ACSC is a sign of the poor overall quality of care, even if the ACSC episode itself is managed well.

This data briefing considers patterns of admissions for ACSCs in terms of age, sex, condition, socioeconomic group and local authority area. The authors analyse these patterns and assess the potential for reducing emergency admissions for ACSCs, highlighting the disease areas and patient groups where the greatest reduction can be achieved.

The briefing concludes that the number of emergency hospital admissions for ACSCs could be reduced by:

  • 18 per cent (potentially saving £238 million) if all local authorities performed at the level of the best-performing local authorities

  • 8 per cent (potentially saving £96 million)  if each local authority improved their service to the level of the next best  local authorities

  • 11 per cent (potentially saving £136 million) if the poorer (than the average) performing local authorities performed at the level of the better (than the average) ones.

This briefing highlights for commissioners the opportunities for improving the quality of care and saving costs that reducing emergency hospital admissions for ACSCs presents. To realise the potential savings, changes will be needed in the management and prevention of these conditions.

Read Nigel's blog: Managing ACSCs: how can avoidable hospital admissions be reduced?