CCG alert: readmissions

Showing posts with label readmissions. Show all posts

31 October 2020

A retrospective database study using synthetic controls of an NHS hospital in Wolverhampton integrated with 10 general practices, providing primary medical services for 67 402 registered patients.
Across the 10 practices, pooled rates of ED attendances did not change significantly after vertical integration. However, there were statistically significant reductions in the rates of unplanned hospital admissions and unplanned hospital readmissions per 100 patients per month. These effect sizes represent 888 avoided unplanned hospital admissions and 168 readmissions for a population of 67 402 patients per annum. Utilising NHS reference costs, the estimated savings from the reductions in unplanned care are ∼£1.7 million.

New research indicates that emergency readmissions to hospital grew by 9% over the last year. The increase for emergency readmissions where someone has returned to hospital within just one day of discharge has increased by 15% year on year.
New data shows no correlation between DToC reductions and rising emergency readmissions.

What do the numbers say about emergency readmissions to hospital?
HealthWatch October 2017
Analysis of the number of people readmitted within the 30-day period after discharge, as well as information about why they were readmitted 2013- 2016 found that:

The number of emergency readmissions has risen over the last five years by 22.8%, from 372,805 to 457,880.
The number of emergency readmissions within 24 hours of discharge has risen by 29.2%, from 49,529 to 63,964.
The number of readmissions within 48 hours has risen by 27%, from 77,927 to 98,955.
Readmissions within 48 hours account for more than 1 in 5 (21.61%) of the total.

This analysis uses Hospital Episode Statistics (HES) data to look at emergency readmission rates split by day of their previous discharge.
The report concludes that "it is not possible to determine whether this variation is due to differences in quality of care and/or service provision, or due to differences in the case-mix of patients."
Key findings
Emergency readmissions within seven days of discharge from hospital

The rate of emergency readmissions within seven days of discharge increased over the week from a low of 3.2 per cent for discharges on Mondays, Tuesdays and Wednesdays to a high of 4.9 per cent for discharges on Sundays.
The overall rate of emergency readmissions within seven days of discharge from hospital on a weekend was 4.4 per cent, 1.1 percentage points higher than the corresponding rate for discharges during the rest of the week (3.3 per cent).
Due to changes in the methodology used for the calculation of the emergency readmissions indicator, these results are not comparable to those included in the previous edition of this publication.

Nationally, there is a small amount of variation in the distribution of length of stay by day of admission, ranging from 47 per cent of discharges following an emergency admission on a Saturday having a length of stay of 0 or 1 days to 52 per cent of discharges following an emergency admission on a Thursday having a length of stay of 0 or 1 days, a range of 4 percentage points.

A review of the evidence and potential for use of 'emergency readmissions within 28 days of discharge from hospital' as an indicator within the NHS Outcomes Framework. The review suggests that between 5 percent and 59 percent of emergency readmissions may be avoidable, with a level of 15 percent up to 20 percent considered reasonable.