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Identifying patient-level health and social care costs for older adults discharged from acute medical units in England

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posted on 2016-02-02, 11:17 authored by M. Franklin, V. Berdunov, J. Edmans, Simon Conroy, J. Gladman, L. Tanajewski, G. Gkountouras, R. A. Elliott
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%).

History

Citation

Age Ageing, 2014, 43 (5), pp. 703-707

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Health Sciences

Version

  • AM (Accepted Manuscript)

Published in

Age Ageing

Publisher

Oxford University Press (OUP)

issn

0002-0729

eissn

1468-2834

Acceptance date

2014-04-23

Copyright date

2014

Available date

2016-02-02

Publisher version

http://ageing.oxfordjournals.org/content/43/5/703

Language

en

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