A recent report from The Health Foundation examines the rise in emergency admissions and looks for possible causes.
The last 15 years have seen a 50% increase in the number of emergency admissions, despite the work being undertaken through policies such as Better Care Fund, Sustainability and Transformation Programmes etc, to identify and divert ‘avoidable’ admissions.
Last year alone there were almost six million emergency admissions, costing in excess of £16 billion and representing approximately 70% of all hospital beds in England. The Health Foundation felt that this increase in emergency admissions could not solely be attributable to an ageing population – the reason often trotted out – as the number of people aged 65+ has increased by only half the rate of growth of emergency admissions. So what other factors could be adding to this increase?
The Health Foundation decided to look at one of the success stories of the NHS – the improvement in survival rates for patients undergoing surgery for acute, life-threatening conditions – and asked the question is this having the unintended consequence of leaving us with a growing population of frail patients who are more at risk of a hospital admission?
To answer the question, the Health Foundation looked at nine million patients, during the time period 2000 – 2009 who presented with a first admission for an acute condition such as stroke or heart attack, and then they counted every subsequent emergency admission they had in the following two years. The findings demonstrated that, year on year, more patients survived their first admission than in the previous year, but all surviving patients also demonstrated more emergency admissions following their first acute admission. The study was able to show that improved survival rates accounted for almost 37% of the total increase in emergency admissions.
So what does this mean for the NHS?
The study revealed an estimated increase of 426,000 emergency admissions in 2012 was due to improved survival rates, costing around £1billion every year – and this excludes further improvements in survival rates post 2009.
Current policies to reduce emergency admissions are targeted at avoidable admissions, however, this study demonstrates that many emergency admissions are actually related to the success of the NHS in saving more patients.
Read the full report from the Health Foundation here.