Evaluation of interventions to reduce hospital admissions

Full title: Interventions to reduce emergency department attendances or hospital admissions from long term care facilities: what’s the economic evidence?

Most care home residents are older adults, living with complex health and care needs.

Emergency hospital admissions may be needed to address acute or urgent health concerns. However, admission to hospital may also be hazardous for older adults, leading to infection, deterioration in cognitive impairment, delirium and loss of functioning.

Preventing non-essential admissions is good for residents, but it also reduces demand/costs for health services. We have recently published a review of effective interventions to reduce hospital attendances and admissions from care homes.

We found high quality evidence from randomised controlled trials (the ‘gold standard’) for:

• advanced care planning;
• goals of care setting;
• nurse practitioner input;
• palliative care intervention;
• flu vaccination;
• enhancing access to intravenous treatments in care homes.

In this project, we will build on that work, to look at what the economic evidence says about effective interventions to reduce hospital admissions and attendances from care homes.

Aims

This research aims to summarise the economic evaluation evidence for effective interventions to reduce hospital attendances and admissions from care homes.

Methods

We will use rapid review methods to achieve a timely summary of evidence. We will focus first on interventions that are supported with randomised controlled trial evidence.

If data are limited, we may extend the study to include interventions supported with less robust evidence. In all aspects we will prioritise contemporary evidence.

Policy Relevance

This review will assist with prioritising interventions that can appropriately reduce attendances and admissions to hospital from care homes, without adverse effects on the health and wellbeing of residents.

It will also identify gaps in the evidence base, where effective interventions have not been the subject of economic evaluations.

Delivery timelines

June – September 2023.