What is the extent of potentially avoidable admissions amongst hospital inpatients with palliative care needs?

Background There is clear evidence that the full range of services required to support people dying at home are far from being implemented, either in England or elsewhere. No studies to date have attempted to identify the proportion of hospital admissions that could have been avoided amongst patien...

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Main Authors: Gott, Merryn, Gardiner, Clare, Ingleton, Christine, Cobb, Mark, Noble, Bill, Bennett, Michael I., Seymour, Jane
Format: Article
Published: BioMed Central 2013
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Online Access:https://eprints.nottingham.ac.uk/2741/
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author Gott, Merryn
Gardiner, Clare
Ingleton, Christine
Cobb, Mark
Noble, Bill
Bennett, Michael I.
Seymour, Jane
author_facet Gott, Merryn
Gardiner, Clare
Ingleton, Christine
Cobb, Mark
Noble, Bill
Bennett, Michael I.
Seymour, Jane
author_sort Gott, Merryn
building Nottingham Research Data Repository
collection Online Access
description Background There is clear evidence that the full range of services required to support people dying at home are far from being implemented, either in England or elsewhere. No studies to date have attempted to identify the proportion of hospital admissions that could have been avoided amongst patients with palliative care needs, given existing and current local services. This study aimed to examine the extent of potentially avoidable admissions amongst hospital patients with palliative care needs. Methods A cross sectional survey of palliative care needs was undertaken in two acute hospitals in England. Appropriateness of admission was assessed by two Palliative Medicine Consultants using the following data collected from case notes: reasons for admission; diagnosis and co-morbidities; age and living arrangements; time and route of admission; medical and nursing plan on admission; specialist palliative care involvement; and evidence of cognitive impairment. Results A total of 1359 inpatients were present in the two hospitals at the time of the census. Of the 654 consenting patients/consultees, complete case note data were collected for 580 patients; the analysis in this paper relates to these 580 patients. Amongst 208 patients meeting diagnostic and prognostic criteria for palliative care need in two acute settings in England, only 6.7% were identified as ‘potentially avoidable’ hospitalisations. These patients had a median age of 84. Half of the patients lived in residential or nursing homes and it was concluded that most could have received care in this setting in place of hospital.
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spelling nottingham-27412020-05-04T16:35:46Z https://eprints.nottingham.ac.uk/2741/ What is the extent of potentially avoidable admissions amongst hospital inpatients with palliative care needs? Gott, Merryn Gardiner, Clare Ingleton, Christine Cobb, Mark Noble, Bill Bennett, Michael I. Seymour, Jane Background There is clear evidence that the full range of services required to support people dying at home are far from being implemented, either in England or elsewhere. No studies to date have attempted to identify the proportion of hospital admissions that could have been avoided amongst patients with palliative care needs, given existing and current local services. This study aimed to examine the extent of potentially avoidable admissions amongst hospital patients with palliative care needs. Methods A cross sectional survey of palliative care needs was undertaken in two acute hospitals in England. Appropriateness of admission was assessed by two Palliative Medicine Consultants using the following data collected from case notes: reasons for admission; diagnosis and co-morbidities; age and living arrangements; time and route of admission; medical and nursing plan on admission; specialist palliative care involvement; and evidence of cognitive impairment. Results A total of 1359 inpatients were present in the two hospitals at the time of the census. Of the 654 consenting patients/consultees, complete case note data were collected for 580 patients; the analysis in this paper relates to these 580 patients. Amongst 208 patients meeting diagnostic and prognostic criteria for palliative care need in two acute settings in England, only 6.7% were identified as ‘potentially avoidable’ hospitalisations. These patients had a median age of 84. Half of the patients lived in residential or nursing homes and it was concluded that most could have received care in this setting in place of hospital. BioMed Central 2013-02-18 Article PeerReviewed Gott, Merryn, Gardiner, Clare, Ingleton, Christine, Cobb, Mark, Noble, Bill, Bennett, Michael I. and Seymour, Jane (2013) What is the extent of potentially avoidable admissions amongst hospital inpatients with palliative care needs? BMC Palliative Care, 12 (Februa). 8/1-8/8. ISSN 1472-684X Palliative care needs End of life Avoidable admissions Inappropriate admissions Survey Acute hospital http://www.biomedcentral.com/1472-684X/12/9/abstract doi:10.1186/1472-684X-12-9 doi:10.1186/1472-684X-12-9
spellingShingle Palliative care needs
End of life
Avoidable admissions
Inappropriate admissions
Survey
Acute hospital
Gott, Merryn
Gardiner, Clare
Ingleton, Christine
Cobb, Mark
Noble, Bill
Bennett, Michael I.
Seymour, Jane
What is the extent of potentially avoidable admissions amongst hospital inpatients with palliative care needs?
title What is the extent of potentially avoidable admissions amongst hospital inpatients with palliative care needs?
title_full What is the extent of potentially avoidable admissions amongst hospital inpatients with palliative care needs?
title_fullStr What is the extent of potentially avoidable admissions amongst hospital inpatients with palliative care needs?
title_full_unstemmed What is the extent of potentially avoidable admissions amongst hospital inpatients with palliative care needs?
title_short What is the extent of potentially avoidable admissions amongst hospital inpatients with palliative care needs?
title_sort what is the extent of potentially avoidable admissions amongst hospital inpatients with palliative care needs?
topic Palliative care needs
End of life
Avoidable admissions
Inappropriate admissions
Survey
Acute hospital
url https://eprints.nottingham.ac.uk/2741/
https://eprints.nottingham.ac.uk/2741/
https://eprints.nottingham.ac.uk/2741/