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Trends in emergency admission and discharge

Trends in emergency admission and discharge. Steve Kendrick ISD Scotland www.isdscotland.org/wholesystem Nursing Strategy Programme Discharge Developments across North Glasgow August 17 th , 2005. Stobhill Hospital. Why the increase?.

stephen-david
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Trends in emergency admission and discharge

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  1. Trends in emergency admission and discharge Steve Kendrick ISD Scotland www.isdscotland.org/wholesystem Nursing Strategy Programme Discharge Developments across North Glasgow August 17th, 2005. Stobhill Hospital

  2. Why the increase? • Population change – more of oldest old: some effect (20%) – likely to become more powerful driver • Population not getting sicker – but more frail elderly at home – and living alone. • Patterns of social change – some effect • Main driver has been the structure of the care system – lack of preventative, continuous care – emergency admission as default.

  3. 7 and 28 day emergency readmission rates. Medical inpatients. Stobhill and Scotland 1991 to 2000.

  4. 7 and 28 day emergency readmission rates. Surgical inpatients. Stobhill and Scotland 1991 to 2000.

  5. 7 and 28 day emergency readmission rates. Surgical day cases. Stobhill and Scotland 1991 to 2000.

  6. Predicting likelihood of future emergency admissions (2001) on basis of age, diagnosis and previous history of emergency admissions (1996 – 2000) 1996 1997 1998 1999 2000 2001 Age at end 2000

  7. Admissions (2001) linked to Delayed Discharge Censuses andadmissions in previous five years 1996 1997 1998 1999 2000 2001 Age, diagnosis etc.on admission

  8. ICD10 codes Diagnosis Admitted Delayed Per cent delayed F01, F03, G30 Dementia, Alzheimer's 2270 621 27.4% I60 to I69 Stroke 6386 714 11.2% R26 Difficulty walking etc. 1705 299 17.5% R41 Confusion, disorientation 997 168 16.9% R54 Senility 927 172 18.6% S72 Hip fracture 4375 438 10.0% Probability of delayed discharge after psychiatric or emergency inpatient admission: the main high probability diagnoses Scotland 2001.

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