Focus on…

23 October 2013
© Nuffield Trust and Health Foundation

© Nuffield Trust
Focus on: a series of in-depth reports
Each year the programme will produce a number of indepth analyses into specific top...
Focus on preventable admissions
Ian Blunt

23 October 2013
© Nuffield Trust and Health Foundation

© Nuffield Trust
A way of categorising “preventable” admissions?
• For certain conditions, the risk of a crisis leading to
emergency hospit...
Analytical approach
•

Hospital Episode Statistics data
from 2001 to 2013

•

Valid age, sex and English LSOA

•

Victoria...
700
600
500
400
300
200
100

QualityWatch

© Nuffield Trust and Health Foundation

NHS OF 2.3i

2012/13

2011/12

2010/11
...
© Nuffield Trust and Health Foundation
The influence of deprivation

© Nuffield Trust and Health Foundation
Variation in 2012/13

© Nuffield Trust and Health Foundation
Variation by condition in 2012/13

© Nuffield Trust and Health Foundation
Large but uneven increases since 2001

© Nuffield Trust and Health Foundation
Increases swamp reductions…

© Nuffield Trust and Health Foundation
Change relative to financial constraints

© Nuffield Trust and Health Foundation
Conclusion
• Importance of understanding rate and trend for each
condition at local level
• Deprivation an important facto...
www.qualitywatch.org.uk

Sign-up for our newsletter
www.qualitywatch.org.uk/newsletter
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Twitter.com/Q...
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Ian Blunt: Focus on preventable admissions

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Ian Blunt: Focus on preventable admissions

  1. 1. Focus on… 23 October 2013 © Nuffield Trust and Health Foundation © Nuffield Trust
  2. 2. Focus on: a series of in-depth reports Each year the programme will produce a number of indepth analyses into specific topics in health and social care using a range of methods. • Accessibility of acute services • Trends in preventable emergency admissions • Analysis of patterns of antidepressant prescribing during the recession • Access to social care for older people • Changes in quality for people with hip fractures © Nuffield Trust and Health Foundation
  3. 3. Focus on preventable admissions Ian Blunt 23 October 2013 © Nuffield Trust and Health Foundation © Nuffield Trust
  4. 4. A way of categorising “preventable” admissions? • For certain conditions, the risk of a crisis leading to emergency hospital admission can be reduced by timely and effective self-care, primary or community care • A subset of these conditions has been identified as potential indicators of how well health services are managing care to avoid the problems that require emergency admissions. • This technique for quality measurement was developed in the USA in the early 1990s – now in many countries, including NHS Outcomes Framework © Nuffield Trust and Health Foundation
  5. 5. Analytical approach • Hospital Episode Statistics data from 2001 to 2013 • Valid age, sex and English LSOA • Victoria State Health Department list of ACS conditions + tuberculosis • Age/sex–specific admission rates using ONS population estimates • Deprivation measured by Indices of Multiple Deprivation 2010 © Nuffield Trust and Health Foundation
  6. 6. 700 600 500 400 300 200 100 QualityWatch © Nuffield Trust and Health Foundation NHS OF 2.3i 2012/13 2011/12 2010/11 2009/10 2008/09 2007/08 2006/07 2005/06 2004/05 2003/04 0 2002/03 Which conditions are included can make a big difference -chronic ACS admissions in Chichester, for example… 800 2001/02 “ACS” often used as an aggregate term, but no standard definition (Purdy 2009) Indirectly standardised rate (ISR) per 100,000 population The conditions matter
  7. 7. © Nuffield Trust and Health Foundation
  8. 8. The influence of deprivation © Nuffield Trust and Health Foundation
  9. 9. Variation in 2012/13 © Nuffield Trust and Health Foundation
  10. 10. Variation by condition in 2012/13 © Nuffield Trust and Health Foundation
  11. 11. Large but uneven increases since 2001 © Nuffield Trust and Health Foundation
  12. 12. Increases swamp reductions… © Nuffield Trust and Health Foundation
  13. 13. Change relative to financial constraints © Nuffield Trust and Health Foundation
  14. 14. Conclusion • Importance of understanding rate and trend for each condition at local level • Deprivation an important factor to consider – but leave much variation unexplained • Rates of admission for some conditions have reduced, but many more have increased (including some where substantial policy effort has been applied) • General trends are being maintained, so far… © Nuffield Trust and Health Foundation
  15. 15. www.qualitywatch.org.uk Sign-up for our newsletter www.qualitywatch.org.uk/newsletter Follow us on Twitter: Twitter.com/Quality_Watch 23 October 2013 © Nuffield Trust and Health Foundation
  16. 16. www.qualitywatch.org.uk

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