Room for one more? A review of the literature on ‘inappropriate’ admissions to hospital for older people in the English NHS

Thwaites, Rachel and Glasby, Jon and Le Mesurier, Nick and Littlechild, Rosemary (2017) Room for one more? A review of the literature on ‘inappropriate’ admissions to hospital for older people in the English NHS. Health & Social Care in the Community, 25 (1). pp. 1-10. ISSN 0966-0410

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Abstract

This paper reports the findings of a review of the literature on emergency admissions to hospital for older people in the UK, undertaken between May and June 2014 at the Health Services Management Centre, University of Birmingham. This review sought to explore: the rate of in/appropriate emergency admissions of older people in the UK; the way this is defined in the literature; solutions proposed to reduce the rate of inappropriate admissions; and the methodological issues which particular definitions of ‘inappropriateness’ raise. The extent to which a patient perspective is included in these definitions of inappropriateness was also noted, given patient involvement is such a key policy priority in other areas of health policy. Despite long-standing policy debates, relatively little research has been published on formal rates of ‘inappropriate’ emergency hospital admissions for older people in the UK NHS in recent years. What has been produced indicates varying rates of in/appropriateness, inconsistent ways of defining appropriateness and a lack of focus on the possible solutions to address the problem. Significantly, patient perspectives are lacking, and we would suggest that this is a key factor in fully understanding how to prevent avoidable admissions. With an ageing population, significant financial challenges and a potentially fragmented health and social care system, the issue of the appropriateness of emergency admission is a pressing one which requires further research, greater focus on the experiences of older people and their families, and more nuanced contextual and evidence-based responses.

Keywords:Older People, Emergency Admission, Hospital Admission, Prevention
Subjects:B Subjects allied to Medicine > B990 Subjects Allied to Medicine not elsewhere classified
Divisions:College of Social Science > School of Social & Political Sciences
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ID Code:29067
Deposited On:16 Nov 2017 14:54

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