Trends in emergency admissions per death

Abstract

446 British Journal of Healthcare Management 2014 Vol 20 No 9 © 2 01 4 M A H ea lth ca re L td death may be a useful way of gauging the number of admissions per person over a lifetime, i.e. at any point in time emergency admissions are occurring at all points of the population’s life-cycle. In this respect, Figure 1 gives the monthly number of emergency admissions per death (both in and out of hospital) from February 2009 to February 2014. A seasonal profile is evident and this is shown in Figure 2. Deaths generally peak in January/ February; as do emergency admissions. However, deaths peak more strongly than emergency admissions and this leads to the summer peak in the ratio of emergency admissions per death. Since many emergency admissions are not directly linked to end of life, we can use this ratio as a rough snapshot of the average emergency admissions per person per lifetime. This assumption holds roughly true when births and deaths are matched. There were 1.43 births per death in England in 2013, so any ratio will be biased toward childhood emergency admissions. So how do we explain the very high figure of 11.5 (annual average) per death? First, we adjust for the current ratio of 1.43 births per death which brings the figure of 11.5 down to somewhere around 8 per death. Table 1 provides further useful insight. Admission to speciality accident and emergency (A&E) are mainly assessment unit admissions, and prior to 2002/03 was fairly constant at 2.2% of total emergency admissions. The A&E four-hour target changed all that, and by 2009/10, this had risen to 12.3% of emergency admissions. Rod Jones Trends in emergency admissions per death