GPs should consider risks of hospital admission for pneumonia patients, says NICE
07 November 2014
GP emergency admissions to hospitals have fallen by 17% in the past decade, contrasting with an increase of 72% in the number of emergency admissions from A&E departments into hospital.
A study, published today in the Journal of the Royal Society of Medicine, found that emergency hospital admissions by GPs fell from 1.12m in 2001/02 to 0.93m in 2010/11, with admissions from A&E rising from 2.1 million to 3.6 million in the same period.
The study authors suggest that demographic changes are partly responsible and claim that ‘increased failure of management’ in primary care – where access problems or unmet expectations see patients presenting at A&E – accounts for the rest of the change.
But GP urgent care leads have previously explained the pressures were to do with a lack of A&E consultants, leaving increasing numbers of ‘risk averse’ junior doctors to admit more patients.
Lead author, Thomas Cowling from the School of Public Health at Imperial College London, said: ‘Whatever the explanation, the role of A&E departments as portals for emergency admission has grown, despite efforts to reduce A&E attendance rates.
‘A&E staff now have increased responsibility as gatekeepers for inpatient care and as care coordinators, which is not reflected in how A&E departments’ activity is measured or reimbursed.’