QualityWatch: Focus on preventable admissions Trends in emergency admissions for ambulatory care sensitive conditions, 2001 to 2013

October 2013

Ian Blunt
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Key points

  • Analysis used anonymised records of all hospital admissions in England between April 2001 and March 2013; nearly 200 million episodes of care.
  • 20% of emergency admissions were for ACS conditions and the rate of admission (standardising for age and sex) has grown by 26% since 2001/02.
  • There was also considerable variation in rates of admission between areas. A substantial amount of the variation is related to deprivation, but the variation that does not seem to be related to deprivation implies that reductions in ACS admissions can be achieved in areas with higher rates; but only if approaches developed in areas with lower rates can be transferred effectively.
  • Trends in admission do not appeared to have changed significantly since the introduction of current financial constraints.

This QualityWatch report, published in partnership with the Nuffield Trust, explores patterns of emergency admissions across England for people with ambulatory care sensitive conditions.

For many years, clinicians, managers and policy-makers have tried various strategies to reduce hospital admissions, but rates have continued to increase. A particular focus has been on patients with conditions where timely access to high quality primary and preventive care can avoid the need for hospital admission in most cases.

These conditions are known as ambulatory care sensitive (ACS). Aggregate rates of emergency admissions for ACS conditions are commonly used to measure how well the health system is preventing unplanned hospital use. We were interested to understand how these rates varied across areas, and how they have changed over time – particularly in relation to the recent financial constraints introduced in the NHS.

QualityWatch is a major research programme providing independent scrutiny into how the quality of health and social care is changing over time.

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