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Quality Measurement Framework

Emergency Admissions

NHS National Services Scotland ISD Scotland & NHS National Services Scotland

Emergency Admissions

The Emergency Admissions quality outcome indicator considers both the:

  • Rate of emergency admissions per 100,000 population for all age groups; and
  • Rate of emergency bed days per 100,000 population for all age groups.

The quality outcome indicator includes both the number of emergency admissions and emergency bed days as they balance each other, e.g. it would be possible for bed days to increase while the number of admissions reduced if people were kept in hospital for longer.

A decrease in the rate of emergency admissions and emergency bed days is desirable over time. Assistance with self management, enhanced access to diagnostics and urgent day care or ambulatory assessment, and a move towards more proactive, anticipatory care and support in the community are expected to facilitate this. These are key aspects of the Scottish Government’s healthcare 2020 vision.

Indicator Update

The rate of emergency admissions increased between 2011-12 and 2013-14 while the rate of emergency bed days remained level over this time, implying shorter lengths of stay over time.

Since 2011-12 the rate of emergency admissions has remained level at around 10,000 emergency admissions per 100,000 population, with slight increases since 2011/12 (latest figure is 10,572 for 2015/16) while emergency bed days per 100,000 population have remained level at around 74,000 until a decrease in 2015 (latest figure is 73,210 for 2015/16).

The emergency admission rate is strongly related to patient age and to deprivation. Rates of Emergency admissions rise with increasing age group from 10-14 onwards, with patients aged 85+ having 11 times more emergency admissions per 100,000 than 15-19 year olds and 7 times more than 45-49 year olds.

Source: latest results published in October 2016 by ISD

Work that should result in improvement in this indicator

For all age groups, this outcome indicator should demonstrate the outcome of improved partnership working between the acute, primary and community care sectors. This includes work to improve health and wellbeing through a wide range of approaches and early interventions, work to reduce accidents and improve safety in the home, work focussed on reducing the incidence of particular health conditions and work on providing support for carers.

For adults and older people, this outcome indicator should represent a shift from a reliance on hospital inpatient care towards proactive and coordinated care and support in the community. It should demonstrate the effectiveness of anticipatory care, identifying people who are at risk of emergency hospital admission, supporting people to be more confident in managing their long term conditions and providing coordinated care and support at home where safe and appropriate.

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