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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

Authors

Merryn Gott

Clare Gardiner

Christine Ingleton

Mark Cobb

Bill Noble

Michael I. Bennett

Jane Seymour

Abstract

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.

Journal Article Type Article
Publication Date Feb 18, 2013
Journal BMC Palliative Care
Electronic ISSN 1472-684X
Publisher Humana Press
Peer Reviewed Peer Reviewed
Volume 12
Issue Februa
Article Number 8
Institution Citation Gott, M., Gardiner, C., Ingleton, C., Cobb, M., Noble, B., Bennett, M. I., & Seymour, J. (2013). What is the extent of potentially avoidable admissions amongst hospital inpatients with palliative care needs?. BMC Palliative Care, 12(Februa), doi:10.1186/1472-684X-12-9
DOI https://doi.org/10.1186/1472-684X-12-9
Keywords Palliative care needs, End of life, Avoidable admissions, Inappropriate admissions, Survey, Acute hospital
Publisher URL http://www.biomedcentral.com/1472-684X/12/9/abstract
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0




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