Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-11T09:23:27.190Z Has data issue: false hasContentIssue false
  • English
  • Français

Who knows best? Older people’s and practitioner contributions to understanding and preventing avoidable hospital admissions

Published online by Cambridge University Press:  27 February 2019

Jon Glasby ,
Rosemary Littlechild ,
Nick Le Mesurier  and
Rachel Thwaites
Jon Glasby*
Affiliation:
School of Social Policy, University of Birmingham, Birmingham, UK
Rosemary Littlechild
Affiliation:
Department of Social Policy and Social Work, University of Birmingham, Birmingham, UK
Nick Le Mesurier
Affiliation:
Health Services Management Centre, University of Birmingham, Birmingham, UK
Rachel Thwaites
Affiliation:
School of Social and Political Sciences, University of Lincoln, Lincoln, UK
*
*Correspondence to: Prof. Jon Glasby, Head of School, School of Social Policy, Muirhead Tower, Room 827, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. Email: J.Glasby@bham.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Whenever there are well-publicised pressures on acute care, there is a tendency for policy makers and the media to imply that a significant number of older people may be taking up hospital beds when they do not really need the services provided there. However, evidence to back up such claims is often lacking, and existing research tends to fail to engage meaningfully with older people themselves. In contrast, this research explores the emergency hospital admissions of older people in three English case study sites, drawing on the lived experience of older people and the practice wisdom of front-line staff to explore the appropriateness of each admission and scope for alternatives to hospital. Contrary to popular opinion, the study did not find evidence of large numbers of older people being admitted to hospital inappropriately. Indeed, some of the older people concerned delayed seeking help and only ended up at hospital as a very last resort, possibly due to concerns about being seen as a burden on scarce public resources. While older people and front-line staff identified a number of suggestions to improve services in future, there seemed few clear cut, easy answers to the longstanding dilemma of how best to reduce emergency admissions. Seeking to understand and potentially reduce emergency hospital admissions is complex, and it is important to consider the experiences and expertise of older people and front-line staff.

Keywords

older peopleemergency hospital admissionspreventionuser involvement
Type
Articles
Information
Health Economics, Policy and Law , Volume 15 , Issue 2 , April 2020 , pp. 225 - 246
Copyright
© Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

BBC (2016) Doctors urge chancellor to increase social care funding, BBC, 12 March, http://www.bbc.co.uk/news/health-35785848 [10 April 2016].Google Scholar
Braun, V and Clarke, V (2006) Using thematic analysis in psychology. Qualitative Research in Psychology 3(2): 77–101.CrossRefGoogle Scholar
Carmody, J, Traynor, V and Marchetti, E (2015) Barriers to qualitative dementia research: the elephant in the room. Qualitative Health Research 25(7): 1013–1019.CrossRefGoogle ScholarPubMed
Ellins, J, Glasby, J, Tanner, D, McIver, S, Davidson, D, Littlechild, R, Snelling, I, Miller, R, Hall, K, Spence, Kthe Care Transitions Project co-researchers (2012) Understanding and improving transitions of older people: a user and carer centred approach. NIHR Service Delivery and Organisation programme.Google Scholar
Fielding, J (2001) ‘Coding and managing data’, In: N. Gilbert (ed.) Researching Social Life. London: Sage, 227–251.Google Scholar
Gale, NK, et al. (2013) Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Medical Research Methodology 13, 117–124.CrossRefGoogle ScholarPubMed
Glasby, J and Littlechild, R (2000) Fighting fires? – emergency hospital admission and the concept of prevention. Journal of Management in Medicine 14(2): 109–118.CrossRefGoogle ScholarPubMed
Glasby, J and Littlechild, R (2001) Inappropriate admissions: patient participation in research. British Journal of Nursing 10(11): 738–741.CrossRefGoogle ScholarPubMed
Imison, C, Poteliakhoff, E and Thompson, J (2012) Older People and Emergency Bed Use: Exploring Variation. London: King’s Fund.Google Scholar
Littlechild, R and Glasby, J (2000) ‘Older people as “participating patients”’, In: H. Kemshall and R. Littlechild (eds) User Involvement and Participation in Social Care. London: Jessica Kingsley, 143–158.Google Scholar
Littlechild, R and Glasby, J (2001) Emergency hospital admissions: older patients’ perceptions. Education and Ageing 16(1): 77–89.Google Scholar
National Audit Office (2018) Reducing Emergency Admissions. London: NAO.Google Scholar
Prynne, M (2014) NHS 111 phoneline should be ‘enhanced’ to ease A&E burden, The Telegraph, 19 August, http://www.telegraph.co.uk/health/nhs/11044617/NHS-111-phone-line-should-be-enhanced-to-ease-AandE-burden.html [3September 2014].Google Scholar
Robson, C (2011) Real World Research 3r edn, Chichester: John Wiley, 474–488.Google Scholar
Thwaites, R, Glasby, J, le Mesurier, N and Littlechild, R (2015) Room for one more? A review of the literature on ‘inappropriate’ admissions to hospital for older people in England. Health and Social Care in the Community (advance online access).CrossRefGoogle Scholar
Triggle, N (2012) Organise urgent care better, NHS told, BBC Website, 9 August, http://www.bbc.co.uk/news/health-19181905 [3 September 2014].Google Scholar
Wright, O (2013) Hospital A&Es swamped by 500,000 elderly victims of neglect, The Independent, 21 November, http://www.independent.co.uk/life-style/health-and-families/health-news/hospital-aes-swamped-by-500000-elderly-victims-of-neglect-8955399.html [3 September 2014].Google Scholar