Triumph of hope over experience: Learning from interventions to reduce avoidable hospital admissions identified through an academic health and social care network

Victoria Woodhams, Simon De Lusignan, Shakeel Mughal, Graham Head, Safia Debar, Terry Desombre, Sean Hilton, Houda Al Sharifi

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Internationally health services are facing increasing demands due to new and more expensive health technologies and treatments, coupled with the needs of an ageing population. Reducing avoidable use of expensive secondary care services, especially high cost admissions where no procedure is carried out, has become a focus for the commissioners of healthcare. Method. We set out to identify, evaluate and share learning about interventions to reduce avoidable hospital admission across a regional Academic Health and Social Care Network (AHSN). We conducted a service evaluation identifying initiatives that had taken place across the AHSN. This comprised a literature review, case studies, and two workshops. Results: We identified three types of intervention: pre-hospital; within the emergency department (ED); and post-admission evaluation of appropriateness. Pre-hospital interventions included the use of predictive modelling tools (PARR - Patients at risk of readmission and ACG - Adjusted Clinical Groups) sometimes supported by community matrons or virtual wards. GP-advisers and outreach nurses were employed within the ED. The principal post-hoc interventions were the audit of records in primary care or the application of the Appropriateness Evaluation Protocol (AEP) within the admission ward. Overall there was a shortage of independent evaluation and limited evidence that each intervention had an impact on rates of admission. Conclusions: Despite the frequency and cost of emergency admission there has been little independent evaluation of interventions to reduce avoidable admission. Commissioners of healthcare should consider interventions at all stages of the admission pathway, including regular audit, to ensure admission thresholds dont change.

Original languageEnglish
Article number153
JournalBMC Health Services Research
Volume12
Issue number1
DOIs
Publication statusPublished - 2012

Keywords

  • (MeSH): Hospitalization
  • Health Services Misuse
  • Home Care Services
  • Hospital based [economics organisation and administration]
  • Outcome and Process Assessment (Health Care)

Fingerprint Dive into the research topics of 'Triumph of hope over experience: Learning from interventions to reduce avoidable hospital admissions identified through an academic health and social care network'. Together they form a unique fingerprint.

  • Cite this