Matthew Franklin1, Vladislav Berdunov1, Judi Edmans2, Simon Conroy3, John Gladman2, Lukasz Tanajewski1, Georgios Gkountouras1, Rachel A Elliott1. 1. Division for Social Research in Medicines and Health, School of Pharmacy, University of Nottingham, Nottingham, UK. 2. Division of Rehabilitation and Ageing, School of Community Health Sciences, Medical School, Queens Medical Centre, University of Nottingham, Nottingham, UK. 3. University of Leicester School of Medicine, Room 540, Clinical Sciences Building, Leicester Royal Infirmary, Leicester, UK.
Abstract
BACKGROUND: acute medical units allow for those who need admission to be correctly identified, and for those who could be managed in ambulatory settings to be discharged. However, re-admission rates for older people following discharge from acute medical units are high and may be associated with substantial health and social care costs. OBJECTIVE: identifying patient-level health and social care costs for older people discharged from acute medical units in England. DESIGN: a prospective cohort study of health and social care resource use. SETTING: an acute medical unit in Nottingham, England. PARTICIPANTS: four hundred and fifty-six people aged over 70 who were discharged from an acute medical unit within 72 h of admission. METHODS: hospitalisation and social care data were collected for 3 months post-recruitment. In Nottingham, further approvals were gained to obtain data from general practices, ambulance services, intermediate care and mental healthcare. Resource use was combined with national unit costs. RESULTS: costs from all sectors were available for 250 participants. The mean (95% CI, median, range) total cost was £1926 (1579-2383, 659, 0-23,612). Contribution was: secondary care (76.1%), primary care (10.9%), ambulance service (0.7%), intermediate care (0.2%), mental healthcare (2.1%) and social care (10.0%). The costliest 10% of participants accounted for 50% of the cost. CONCLUSIONS: this study highlights the costs accrued by older people discharged from acute medical units (AMUs): they are mainly (76%) in secondary care and half of all costs were incurred by a minority of participants (10%).
BACKGROUND: acute medical units allow for those who need admission to be correctly identified, and for those who could be managed in ambulatory settings to be discharged. However, re-admission rates for older people following discharge from acute medical units are high and may be associated with substantial health and social care costs. OBJECTIVE: identifying patient-level health and social care costs for older people discharged from acute medical units in England. DESIGN: a prospective cohort study of health and social care resource use. SETTING: an acute medical unit in Nottingham, England. PARTICIPANTS: four hundred and fifty-six people aged over 70 who were discharged from an acute medical unit within 72 h of admission. METHODS: hospitalisation and social care data were collected for 3 months post-recruitment. In Nottingham, further approvals were gained to obtain data from general practices, ambulance services, intermediate care and mental healthcare. Resource use was combined with national unit costs. RESULTS: costs from all sectors were available for 250 participants. The mean (95% CI, median, range) total cost was £1926 (1579-2383, 659, 0-23,612). Contribution was: secondary care (76.1%), primary care (10.9%), ambulance service (0.7%), intermediate care (0.2%), mental healthcare (2.1%) and social care (10.0%). The costliest 10% of participants accounted for 50% of the cost. CONCLUSIONS: this study highlights the costs accrued by older people discharged from acute medical units (AMUs): they are mainly (76%) in secondary care and half of all costs were incurred by a minority of participants (10%).
Authors: Lukasz Tanajewski; Matthew Franklin; Georgios Gkountouras; Vladislav Berdunov; Judi Edmans; Simon Conroy; Lucy E Bradshaw; John R F Gladman; Rachel A Elliott Journal: PLoS One Date: 2015-05-05 Impact factor: 3.240
Authors: Lukasz Tanajewski; Matthew Franklin; Georgios Gkountouras; Vladislav Berdunov; Rowan H Harwood; Sarah E Goldberg; Lucy E Bradshaw; John R F Gladman; Rachel A Elliott Journal: PLoS One Date: 2015-12-18 Impact factor: 3.240
Authors: Rachael M Hunter; Naomi J Fulop; Ruth J Boaden; Christopher McKevitt; Catherine Perry; Angus I G Ramsay; Anthony G Rudd; Simon J Turner; Pippa J Tyrrell; Charles D A Wolfe; Stephen Morris Journal: Health Res Policy Syst Date: 2018-03-14