NIHR Signal Hospital admission rates and costs increase in line with BMI

Each 2kg/m² rise in body mass index (BMI) above the normal-weight threshold in women aged 55-79 leads to a 5% rise in annual hospital admissions and 7% rise in healthcare costs. In England, £662 million of the annual hospital admission costs in 2013 could be attributed to overweight or obesity in women of this age group. 


https://discover.dc.nihr.ac.uk/content/signal-00575/hospital-admission-rates-and-costs-increase-in-line-with-bmi


From the NIHR Dissemination Centre

NIHR Signal Hospital admission rates and costs increase in line with BMI

NIHR Signal Hospital admission rates and costs increase in line with BMI


Each 2kg/m² rise in body mass index (BMI) above the normal-weight threshold in women aged 55-79 leads to a 5% rise in annual hospital admissions and 7% rise in healthcare costs. In England, £662 million of the annual hospital admission costs in 2013 could be attributed to overweight or obesity in women of this age group. 


Published on 20 March 2018 
Full document available at: https://discover.dc.nihr.ac.uk/portal/article/4000975/hospital-admission-rates-and-costs-increase-in-line-with-bmi

In and out of hospital

This report from the British Red Cross proposes introducing automatic home assessments and other simple interventions for elderly and vulnerable people who are often admitted to hospital to reduce avoidable hospital admissions in vulnerable patients. The report contains analysis of first-hand accounts of frontline health and care workers who argue that there are too many missed opportunities to prevent many of these avoidable admissions.

NIHR Signal Study raises questions about NHS “weekend effect”

The increased mortality observed if patients are taken to hospitals at weekends also affects night admissions and can be explained in part by the severity of illness.

Five linked NIHR-funded studies reviewed mortality and time and day of admission to hospital, largely using routine England-wide data.

Fewer people are admitted from A&E at the weekend. Admission is more likely if they have arrived by ambulance or been referred directly for admission from community services. Though death rate within 30 days was slightly higher for these admissions, it is likely that this was due to more severe illness. There was no difference in mortality for people who attended A&E but were not admitted.
NHS Trusts have been told by NHS England to reorganise services in line with “seven day working” to eliminate the weekend effect. These studies raise doubts as to whether such a reorganisation will achieve a reduction in mortality overall.

From the NIHR Dissemination Centre

Hidden hunger and malnutrition in the elderly

This report from the All Party Parliamentary Group on Hunger calls on the government to look more closely at malnutrition in older people which is estimated to cost the NHS and social care £15.7 billion a year by 2030. It argues that targeted investment in services which protect older people from malnutrition would deliver significant annual savings to the NHS, not least by reducing the number of hospital admissions and limiting the number of days older people spend in hospital.

Preventing emergency hospital admissions for children and young people

A briefing from Nuffield Trust looks at the relationship between deprivation and the use of emergency hospital care by children and young people in England.

It describes areas of inequality and explores how they have changed over time. As well as looking at the overall patterns of emergency hospital use, it focuses in particular on three common conditions – asthma, diabetes and epilepsy – where more timely and effective primary, community or outpatient care could prevent admissions.

NHS England enacts winter pressures protocol as services feel strain

NHS England has kicked into gear a series of recommendations to help hospitals handle increased pressure on services, activating the NHS Winter Pressures Protocol.

This includes extending the deferral of all non-urgent inpatient elective care to 31 January, deferring day-case procedures and routine outpatient appointments and advising clinical commissioning groups to temporarily suspend sanctions for mixed sex accommodation breaches.

The measures, put forward by the National Emergency Pressures Panel (NEPP), come in response to strains being felt by NHS services across the country over the festive period.

RCoA survey shows resources needed for vulnerable patients

More than half of anaesthetic doctors would feel uncomfortable with a relative or close friend with dementia being admitted to an NHS hospital this winter, a survey from the Royal College of Anaesthetists (RCoA) has revealed.

The survey, undertaken by the RCoA in collaboration with Alzheimer’s Society, found that 57 per cent of respondents would be uncomfortable with the possibility of a relative or close friend with a diagnosis of dementia receiving treatment in an NHS hospital.

Admissions of inequality: emergency hospital use for children and young people

Does a child's socioeconomic background have an effect on rates of admissions to hospital for common conditions such as asthma, diabetes or epilepsy?  Report from the Nuffield Trust.

Planning for seasonal demand in respiratory illness

Each winter, emergency departments experience a surge in respiratory attendances and emergency admissions for respiratory conditions double. It is therefore crucial to plan for this inevitable increase in demand so that patient flow is maintained.

A “quick guide” from NHS Improvement highlights ways to manage demand, including ambulatory emergency care, early supported discharge services, and urgent “hot” clinics. Use of these initiatives can reduce avoidable overnight admissions and improve patient flow and outcomes.

Local A&E delivery boards are advised to consider the recommendations as part of plans to manage the seasonal surge in respiratory admissions.

Pulmonary rehabilitation associated with lower hospital admission rates

The Pulmonary rehabilitation: Beyond breathing better report from the Royal College of Physicians (RCP) National Chronic Obstructive Pulmonary Disease (COPD) Audit Programme reveals that people who complete a full pulmonary rehabilitation programme are much less likely to be admitted to hospital than those who do not.

Out in the cold: lung disease, the hidden driver of NHS winter pressure

This report from the British Lung Foundation identifies a seasonal trend in respiratory admissions over the last seven years and argues that a failure to address this annual fluctuation is contributing to winter A&E pressures. It argues that community care and support outside of hospital needs to be strengthened and that service planning for a rise in respiratory admissions is needed to manage this seasonal variation.

Surgeons asked to staff hospital front doors to head off emergency pressures this winter

The leaders of the Royal College of Surgeons (RCS) have written to surgeons in England, encouraging them to provide support at hospital front doors (e.g. rapid outpatient clinics and A&E) over the coming months as the NHS faces arguably its toughest winter in modern times. The surgeons have also called on government to make further funding available to the NHS in next week’s Budget.

The RCS says there is strong evidence that having more senior decision-makers at the front door of hospitals reduces unnecessary emergency admissions and delayed discharges, thereby freeing up beds for genuine emergencies and patients needing planned operations.

Physios win praise for cutting hospital admissions

Physiotherapists in Cumbria have been praised for an initiative with social care, which has reduced the number of people who need to be admitted to hospital.

The team worked with social care staff from the local Eden Community Response Team to strengthen assessment and care in the community, so reducing the number of people who need to be admitted to hospital.

Combined Performance Summary - October 2017

This publication from NHS England summarises the data around NHS performance for October 2017. It contains a summary of the monthly performance statistics on:

• NHS 111
• ambulance quality indicators
• A&E attendances and emergency admissions
• waiting times for diagnostic tests, referral to treatment for consultant-led elective care and cancer services;
• delayed transfers of care; and
• early intervention in psychosis

Preparing for winter

The Preparing for winter guidance from the Royal College of Physicians covers the delivery of care, patient flow, wellbeing of the workforce and minimising unnecessary hospital occupancy.

Quarterly monitoring report 24: November 2017

24th quarterly monitoring report form the King's Fund.

Performance against a number of key indicators is worse than at this time last year, and finances remain precarious despite an emergency funding injection.

Physios help reduce London’s neuromuscular emergency admissions

Physiotherapists have helped cut the number of emergency admissions and readmissions for people with neuromuscular conditions in London and the South East over the last five years.

An audit led by consultant neurologist Michael Hanna has revealed that emergency admissions for neuromuscular patients fell from 63 per cent to 32.8 per cent between 2012 and 2017, while readmissions halved from 25.1 per cent to 12.4 per cent.

The mortality rate over the same period dropped from 4.5 per cent to 0.3 per cent, with only one death in the 2017 sample compared to 24 in 2012.

One major factor in these improvements has been better coordination between specialist neuromuscular teams, including physios, and hospital staff. 

NHS pressures – future trends

This BMA analysis of NHS admissions and waiting times data estimates that emergency department attendances could increase to 24 million between October 2017 and September 2018. During this period, the analysis also projects that the number of patients failing to be treated within four hours of arrival at hospital could rise by 370,000.

Monitoring noncommunicable disease commitments in Europe: progress monitor indicators

This report from Macmillan argues that the health and care system is failing to support recovering cancer patients with the physical and emotional trauma following treatment. It argues that the lack of appropriate aftercare is also placing pressure on the NHS with as cancer patients have 60 per cent more A&E attendances and 50 per cent more contact with GPs, 15 months after diagnosis.