Determinants of Emergency Hospital Admissions among Patients in Blackpool, England: Population-Based Cross-Sectional Study




Emergency hospital admissions have been increasing in the UK over recent years [1,2]. With the predicted increase of about 53% in the proportion of people aged 65 and over in the UK between 2001 and 2013 [3] this trend is set to continue as some evidence suggest that the ageing population structure will be associated with increases in the number and frequency of emergency admissions [4]. In addition to its impact on health service resources, hospitalisation can lead to adverse consequences particularly for older people, including breakdown of formal and informal care, loss of social networks, and premature admission to residential care.


 Study population and setting Blackpool is a spearhead unitary local authority in Lancashire, the North West of England with an estimated population of 141,900 [10]. The proportion of those aged 65 and above in Blackpool (19.0%) is significantly higher than the England (16.1%) and the North West (16.4%) averages.There are 22 GP practices in Blackpool and in keeping with the wellknow practice across England, some Blackpool residents are registered with family doctors (GPs) outside Blackpool. The Blackpool Fylde and Wyre NHS Trust (BWFH) is the main provider of inpatient hospital care for Blackpool patients. Some patients use other acute trusts within and outside Lancashire because of proximity, choice or expertise not available at the BFWH. The Lancashire Care NHS Trust (LC) provides adult psychiatric care for Blackpool patients.

Statistical analyses:

Emergency admission rates by the various factors of interest were calculated as a proportion of total admissions with their respective 95% confidence intervals. Logistic regression analyses were carried out to identify and quantify any associations between the variables of interest (see Box 1) and emergency admission. Stats Direct version 2.7.7 was used for calculating the emergency admission rates with 95% confidence intervals while SPSS version 13.0 for Windows was used for all other analyses.


Results :

Emergency admissions There were 196,902 records of admissions among Blackpool patients over the period out of which 61,982 were classified as emergency admissions giving an overall emergency admission rate of 31.5%. Majority (68.2%) of the emergency admissions were via accident and emergency services (code 21), 20.1% were via GP referrals (code 22), 0.4% were via bed bureau (code 23), 2.4% were via consultant outpatient clinics (code 24), while 8.8% were via other means including patients who arrived via the accident and emergency department of other healthcare providers



 The risk of emergency hospital admissions among Blackpool patients has declined over the period covered by this study. Age, socioeconomic deprivation, patient’s GP practice, hospital and specialty of admission, health condition, day and season of admission were independently associated with emergency admission. Collectively these factors explained 56.3% of the variations in emergency admissions. Patient’s sex was however not found to be associated with emergency admissions.

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