Reducing emergency admissions for primary constipation: a pilot study to cut costs in an acute hospital trust

Abstract

Background: Constipation is a common condition that impacts quality of life, often causing psychological distress and incurring considerable healthcare costs in terms of unnecessary emergency admissions due to poor management. Aintree University Hospital has a healthy bowel clinic for treating patients presenting with functional bowel disorders, including constipation, in an outpatient setting. From December 2013 to November 2014, 301 patients were admitted to hospital with a primary diagnosis of constipation, 216 of these through the accident and emergency department, with an average length of stay of 3.3 days. Methods: To prevent unnecessary admission, a successful bid provided £16 000 to fund a 12-month pilot study to develop a new emergency constipation pathway, including an emergency constipation clinic and linked to the main healthy bowel clinic. Results: Over the pilot study period, more than 70 patients were seen through the new pathway, which saved 231 bed days. At an average cost per bed day of £400, this equates to a total annual saving of £92 400. Conclusion: A new emergency pathway linked to an already established outpatient clinic prevented admission of patients presenting with primary constipation.