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Homing in on improved care in the community
- Author:
- IMISON Candace
- Journal article citation:
- Health Service Journal, 20.9.12, 2012, pp.28-29.
- Publisher:
- Emap Healthcare
People over the age of 65 continue to experience high rates of emergency bed admissions. Often the admission is avoidable or the length of stay in hospital longer than necessary. Recent research from the King's Fund found a fourfold variation in emergency bed use by people over the age of 65. The article reports on the reasons for this variation and the lessons that can be learnt from Torbay, who now uses less emergency beds per head of the population (for people over 65) than anywhere else in England.
Older people and emergency bed use: exploring variation
- Authors:
- IMISON Candace, THOMPSON James, POTELIAKHOFF Emmi
- Publisher:
- Kings Fund
- Publication year:
- 2012
- Pagination:
- 24p.
- Place of publication:
- London
This paper explores factors that might be driving the significant variation in use of hospital beds by patients over 65 admitted as an emergency in order to determine what can be learned from those areas with the highest and lowest rates of bed use. The analysis is based on existing Hospital Episode Statistics (HES) data and local population-based data. It considers the contribution made by patient-based factors, hospital factors, the availability of community services and resources, and broader system relationships (such as how care systems and staff work together and relate to each other) in driving the observed variation in length of stay and rate of admission. The findings indicate that there is a significant opportunity to reduce the overall rate of use of emergency hospital beds by people over 65 while at the same time not threatening and potentially improving the quality of patient care. Primary Care Trusts with the highest bed use tended to have excessive lengths of stay for patients for whom hospital was a transition between home and supported living. Areas with lower rates of bed use tended to have well-developed, integrated services for older people. These areas also delivered a good patient experience and had lower readmission rates.