Reducing avoidable use and frequent admissions to accident and emergency and avoiding frequent hospital admissions
Nishani Jeyapalan, Nasreen Ali, Erica Cook
The surge in accident and emergency (A&E) attendance over the last 30 years in the United Kingdom have been correlated with a larger number of patients presenting with ‘avoidable’ conditions that could have been better managed by primary care services (GPs). The avoidable use of A&E encompasses both minor illnesses (can be treated by primary care providers) and self-limiting problems (do not require medical attention). Alongside admissions which could be avoided, frequent admissions (patients that attend A&E from 3 to 12 times within a 12-month period) also put additional strain on emergency medicine. Frequent attenders; consume large amounts of consultation time, also tend to be frequent users of health and social care facilities, have a higher triage category and are more likely to have chronic diseases. The literature has documented socio-demographic factors that might affect avoidable and frequent use of A&E, such as, deprivation, ethnicity, vulnerability, urban/rural status, distance to hospital, age, sex, morbidity and mortality and prevalence of health behaviours such as smoking, alcohol consumption etc. This study will use a mixed-model methodology to gain insight into potentially avoidable admissions and the frequent use of A&E admissions.
Objective 1: Examine the social demographic profiles (the age, ethnicity, date of birth geographical location) of patients that use and are frequently admitted to A&E;
Objective 2: Explore the reasons for the avoidable use and frequent use of patients admitted to A&E;
Objective 3: Ascertain the views of healthcare professionals (staff who assist with patient information and A&E admittance i.e Navigation team and medical liaisons on reasons for patient’s frequent use and frequent admission to A&E.
Which BLMK ICS priorities does the work address?
User-centred health and social care
Equality and diversity
Workforce capacity