Identifying patient-level health and social care costs for older adults discharged from acute medical units in England

Background: Acute medical units allow for those who need admission to be correctly identified, and for those who could be managed in ambulatory settings to be discharged. However, readmission rates for older people following discharge from acute medical units are high and may be associated with subs...

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Main Authors: Franklin, Matthew, Berdunov, Vladislav, Edmans, Judi, Conroy, Simon, Gladman, John R.F., Tanajewski, Lukasz, Gkountouras, Georgios, Elliott, Rachel A.
Format: Article
Published: Oxford University Press 2014
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Online Access:https://eprints.nottingham.ac.uk/41071/
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author Franklin, Matthew
Berdunov, Vladislav
Edmans, Judi
Conroy, Simon
Gladman, John R.F.
Tanajewski, Lukasz
Gkountouras, Georgios
Elliott, Rachel A.
author_facet Franklin, Matthew
Berdunov, Vladislav
Edmans, Judi
Conroy, Simon
Gladman, John R.F.
Tanajewski, Lukasz
Gkountouras, Georgios
Elliott, Rachel A.
author_sort Franklin, Matthew
building Nottingham Research Data Repository
collection Online Access
description Background: Acute medical units allow for those who need admission to be correctly identified, and for those who could be managed in ambulatory settings to be discharged. However, readmission rates for older people following discharge from acute medical units are high and may be associated with substantial health and social care costs. Objective: Identifying patient-level health and social care costs for older people discharged from acute medical units in England. Design: Prospective cohort study of health and social care resource use. Setting: An acute medical unit in Nottingham, England. Participants: 456 people aged over 70 who were discharged from an acute medical unit within 72 hours of admission. Methods: Hospitalisation and social care data were collected for three months post-recruitment. In Nottingham, further approvals were gained to obtain data from general practices, ambulance services, intermediate care and mental healthcare. Resource use was combined with national unit costs. Results: Costs from all sectors were available for 250 participants. Mean (95% CI, median, range) total cost was £1926 (1579-2383, 659, 0-23612). Contribution was: secondary care (76.1%), primary care (10.9%), ambulance service (0.7%), intermediate care (0.2%), mental healthcare (2.1%) and social care (10.0%). The costliest 10% of participants accounted for 50% of the cost. Conclusions: This study highlights the costs accrued by older people discharged from AMUs: they are mainly (76%) in secondary care and half of all costs were incurred by a minority of participants (10%).
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spelling nottingham-410712020-05-04T16:50:33Z https://eprints.nottingham.ac.uk/41071/ Identifying patient-level health and social care costs for older adults discharged from acute medical units in England Franklin, Matthew Berdunov, Vladislav Edmans, Judi Conroy, Simon Gladman, John R.F. Tanajewski, Lukasz Gkountouras, Georgios Elliott, Rachel A. Background: Acute medical units allow for those who need admission to be correctly identified, and for those who could be managed in ambulatory settings to be discharged. However, readmission rates for older people following discharge from acute medical units are high and may be associated with substantial health and social care costs. Objective: Identifying patient-level health and social care costs for older people discharged from acute medical units in England. Design: Prospective cohort study of health and social care resource use. Setting: An acute medical unit in Nottingham, England. Participants: 456 people aged over 70 who were discharged from an acute medical unit within 72 hours of admission. Methods: Hospitalisation and social care data were collected for three months post-recruitment. In Nottingham, further approvals were gained to obtain data from general practices, ambulance services, intermediate care and mental healthcare. Resource use was combined with national unit costs. Results: Costs from all sectors were available for 250 participants. Mean (95% CI, median, range) total cost was £1926 (1579-2383, 659, 0-23612). Contribution was: secondary care (76.1%), primary care (10.9%), ambulance service (0.7%), intermediate care (0.2%), mental healthcare (2.1%) and social care (10.0%). The costliest 10% of participants accounted for 50% of the cost. Conclusions: This study highlights the costs accrued by older people discharged from AMUs: they are mainly (76%) in secondary care and half of all costs were incurred by a minority of participants (10%). Oxford University Press 2014-07-24 Article PeerReviewed Franklin, Matthew, Berdunov, Vladislav, Edmans, Judi, Conroy, Simon, Gladman, John R.F., Tanajewski, Lukasz, Gkountouras, Georgios and Elliott, Rachel A. (2014) Identifying patient-level health and social care costs for older adults discharged from acute medical units in England. Age & Ageing, 43 (5). pp. 703-707. ISSN 0002-0729 Economic evaluation Acute Medical Unit Costing methodology Primary care Secondary care Social care https://academic.oup.com/ageing/article-lookup/doi/10.1093/ageing/afu073 doi:10.1093/ageing/afu073 doi:10.1093/ageing/afu073
spellingShingle Economic evaluation
Acute Medical Unit
Costing methodology
Primary care
Secondary care
Social care
Franklin, Matthew
Berdunov, Vladislav
Edmans, Judi
Conroy, Simon
Gladman, John R.F.
Tanajewski, Lukasz
Gkountouras, Georgios
Elliott, Rachel A.
Identifying patient-level health and social care costs for older adults discharged from acute medical units in England
title Identifying patient-level health and social care costs for older adults discharged from acute medical units in England
title_full Identifying patient-level health and social care costs for older adults discharged from acute medical units in England
title_fullStr Identifying patient-level health and social care costs for older adults discharged from acute medical units in England
title_full_unstemmed Identifying patient-level health and social care costs for older adults discharged from acute medical units in England
title_short Identifying patient-level health and social care costs for older adults discharged from acute medical units in England
title_sort identifying patient-level health and social care costs for older adults discharged from acute medical units in england
topic Economic evaluation
Acute Medical Unit
Costing methodology
Primary care
Secondary care
Social care
url https://eprints.nottingham.ac.uk/41071/
https://eprints.nottingham.ac.uk/41071/
https://eprints.nottingham.ac.uk/41071/