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At the heart of general practice since 1960

Steep rise in emergency readmissions raises patient safety fears

By Nigel Praities

The proportion of emergency readmissions occurring within a day of discharge has leapt by a third in less than a decade, a Department of Health report reveals.

The increase will fuel fears, revealed by Pulse last month, that patients are being put at risk by being moved out of hospital too quickly.

A DH analysis of findings by National Centre for Health Outcomes Development shows there has been a progressive decrease in the length of stay in hospital at the same time as year-on-year increases in readmission rates.

The Government has admitted for the first time that the two trends are linked, although it says correlations between length of stay and readmission are ‘extremely weak' and that it would be ‘simplistic' to blame discharge policy.

The number of patients readmitted to hospital within one day of discharge increased from 11.4% as a proportion of total readmissions in 1998/9 to 14.9% in 2006/7.

The DH figures show the rate of readmissions for adults aged 16 to 74 rose from 7% in 1998/9 to over 9% in 2006/7.

The report says the National Centre for Health Outcomes Development had observed an ‘inverse but weak correlation between the overall raw readmission rates and the corresponding national average length of stay for each age and gender category'.

In subsequent, more detailed DH research ‘we consistently found extremely small correlations', although the report claims this provides ‘no evidence for the hypothesis that decreases in the length of stay have led to a higher rate of avoidable readmissions'.

But Dr Jonathan Fielden, chair of the BMA consultants' committee, said pressure on hospital capacity was partly to blame for the rise in readmissions.

‘There have been radical cuts in the number of inpatient beds across specialties. Most hospital are working over safe maximum capacity and therefore at times of peak demand best practice gets stretched,' he said.

Dr Fielden said patients could be discharged from hospital earlier as long as there was adequate support and back-up from primary care or social services.

Rise in emergency readmissions: More patients are ending up back in hospital Rise in emergency readmissions: patients are ending up back in hospital

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