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Similar to Ian Blunt: Focus on preventable admissions
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Ian Blunt: Focus on preventable admissions
- 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. Focus on preventable admissions
Ian Blunt
23 October 2013
© Nuffield Trust and Health Foundation
© Nuffield Trust
- 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. 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. 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
- 11. Large but uneven increases since 2001
© Nuffield Trust and Health Foundation
- 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
