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Why is this National Indicator important?
Older people admitted regularly to hospital as an emergency are more likely to be delayed there once their treatment is complete. This, in turn, is particularly bad for their health and independence. This indicator aims to reduce the number of older people with multiple emergency admissions to hospital.
A reduction in this indicator would demonstrate the positive effect of alternatives such as more proactive care and management of conditions in the community. It would also lead to a general improvement in the health of over 65s.
This indicator demonstrates the outcome of early interventions. These include anticipatory care and joined-up community and health care services designed to address the challenges of an increasingly ageing population with long-term conditions and complex needs. Some admissions cannot be avoided. But the more comprehensive the alternatives to hospital care, the less likely we make the need for hospital admissions.
What will influence this National Indicator?
A range of factors, some personal, some systems-related, impact on admission numbers. At a personal level, these would include the particular form of the current problem, the individual's own health and well-being and whether the person looks after themselves or needs a carer. Their immediate housing environment is also important; can they, for example, reach an upstairs toilet. Systems-related aspects include: the habits of GPs in referring patients directly to hospital; the availability of alternative forms of care such as short term rapid response services; and whether local systems are linked in a way that supports older people at these critical times.
What is the Government's role?
NHS Boards have a major role in delivering progress on this indicator. It can be achieved by working with local authorities to develop a more joined-up preventative and supportive home care service, and ensuring that people have their needs for care properly assessed through, for example, single shared assessment. The Government encourages continuous improvement through target-setting, the redesign of primary care services and the facilitation of joint working. All of which will improve results for older people.
How are we performing?
Between 1999/2000 and 2008/2009 there had been a gradual but relatively steady increase in the proportion of people aged 65 and over admitted as emergency inpatients two or more times in a single year. The latest figure of 4.9% for 2009/10 represents for the first time a decrease on the figure of 5.1% seen in the previous year.
Source: ISD Linked SMR01 records
Please note that the chart shows a revised figure for 2009/10.
View data on elderly emergencies
This evaluation is based on: any difference within +/- 0.1 percentage points of last year's figure suggests that the position is more likely to be maintaining than showing any change. A decrease of 0.1 percentage points or more suggests the position is improving; whereas an increase of 0.1 percentage points or more suggests the position is worsening.
For information on general methodological approach, please click here.
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