)
Emergency admissions to hospital are costly to the NHS and also cause disruption to planned health care.
Considerable efforts have been made within the health service to reduce emergency admissions, but few primary care trusts have been successful, with some primary care trusts recording an increase.
In order to successfully reduce avoidable emergency admissions, we need to fully understand which interventions are the most effective. The King's Fund commissioned this review of research evidence to establish which interventions work in avoiding emergency or unplanned hospital admissions.
Key questions
This paper aims to address the following questions:
What interventions work in reducing avoidable admissions?
Who is at risk, and how do we identify them?
Which admissions are potentially avoidable?
Which interventions work in:
primary care
emergency care
discharge from hospital.
Findings
The review of available research evidence identified interventions where there is evidence of positive effect on both admissions and re-admissions, those where there is evidence that the intervention has no beneficial effect, and a range of interventions where more evidence is needed to determine whether they have the potential to reduce admissions.
The author emphasises that interventions to reduce emergency admissions take place within a complex environment, in which the nature and structure of existing care services, individual professional attitudes, patient and family preferences, and general attitudes to risk management can affect their implementation. It is also acknowledged that some interventions, although they fail to reduce admissions, may have other beneficial effects, such as reducing length of stay or improving patients' experience of care.
Conclusions
The paper concludes that policy-makers, providers and commissioners can introduce a number of changes that have proved to be effective in reducing admissions and includes recommendations for all of these groups, emphasising the importance of using evidence-based interventions.
Scenes in Channel 4 Dispatches A&E episode truly harrowing
Siva Anandaciva, Chief Analyst of The King's Fund, comments on Channel 4 Dispatches Undercover A&E: NHS in crisis.
)
Activity in the NHS
Over the past 10 years, it's often been stated that the NHS treats more than a million people every 36 hours. But is this statistic still true? We examine the data.
The King's Fund responds to the Liberal Democrats' plan to tackle ambulance delays and corridor care
Sarah Woolnough, Chief Executive of The King's Fund, responds to the latest general election pledge from the Liberal Democrats to tackle ambulance delays and corridor care.
)
NHS waiting times: how are different service waiting times linked?
NHS waiting times are one measure of quality of care. But patient waiting times in one service are often linked to those in another. What can the data tell us about these interdependenci...