7. EFFICIENCY AND PRODUCTIVITY
7.1.2 Can the Department provide the latest
detailed information on numbers of emergency readmissions within
28 days of a prior hospital admission and the underlying
reasons for such readmissions? (Q81)
Answer
1. The most recent available information,
with figures up to and including 2006-07, is contained in the
paper Emergency readmission rates: further analysis sent
to the Committee in October 2008. The detailed analysis in the
paper suggests that there is no simple explanation for the increase
in the rate of emergency readmissions in recent years and that
a number of factors—including changes in demography and
in clinical practice—are involved. Information on the
aggregate rate of emergency readmissions in 2007-08 (separately
for the age groups 0-15, 16-75 and 75 and over) will
be available in the autumn and the Department will send it on
to the Committee as soon as it has been validated. The Department
does not intend to replicate the detailed analysis in the 2008 paper.
Supplementary answer
EMERGENCY READMISSIONS:
UPDATED FIGURES
In our answer to question 81, we referred to
the Department's paper Emergency readmission rates: further
analysis, sent to the Committee in October 2008. This contains
a detailed analysis of trends in emergency readmission rates over
the period 1998-99 to 2006-07, at the time the most recent
information available.
Selected data for 2007-08 are now available
on the website of the National Centre for Health Outcomes Development
(NCHOD) at http://www.nchod.nhs.uk/.
Data are available for England, for individual hospitals, and
for SHAs/PCTs, and relate to the aggregate across all conditions.
The data are available for the age bands 0-15 years, 16-74 years,
and 75 years and over. Data for four specific conditions
(fractured femur, hip replacement, hysterectomy and stroke) are
currently available only up to 2006-07.
Some selected figures at national (England)
level are presented in the attached graphs (fig 81a, b and
c) and tables (81a, b, c and d). Headline results are:
— The aggregate number of emergency readmissions
has continued to increase in all age bands.
— The rates of increase for the most recent
year (2007-08 as an increase on 2006-07) are very similar
in all age bands to those for the immediately previous 12 months,
and are lower than those for the period 2002-03 to 2005-06.
— Rates of emergency readmissions (the
number of emergency readmissions divided by the total number of
hospital episodes over the same period) have also continued to
rise at a broadly similar rate to previous trends.
— As in previous years, the emergency readmission
rate for patients of 75 years and over is substantially greater
than that for the 16-74 age band. The emergency readmission
rate for patients of 0-14 years (not analysed in detail in
the 2008 paper) is now very similar to that for the 16-74 age
band, especially after standardisation for differences in case
mix.
The new data are not comparable to the data
used in the 2008 paper. Apart from the use of a different
year as the base of the standardisation (2003-04 instead
of 2002-03), there have been some changes in definitions—in
particular, patients with an episode of care for cancer are now
excluded from the analysis only if the relevant episode took place
in the 12 months immediately before the emergency readmission,
rather than at any time over the whole period analysed. In addition,
improvements in data quality will have improved NCHOD's ability
to link episodes of care.
Department of Health
November 2009
Figure 81a
Figure 81b
Figure 81c
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