A recent study by the Centre for Health Economics (CHE) found that GP practices which review their dementia patients as part of Quality and Outcomes Framework (QOF) tend to have relatively fewer emergency hospital admissions by persons with dementia. There was a shorter average length of hospital stay for people with dementia discharged to community.
The impacts of QOF were relatively modest however, according to this briefing on the impact of the quality of dementia care upon the interface between primary and secondary care (i.e. concerning the practical scope for reducing hospital admissions, avoidable re-admissions, length of stay etc).
Higher quality dementia care. York: Centre for Health Economics (University of York), January 28th 2016.
This relates to an earlier article:
Kasteridis, P. Mason, AR. [and] Goddard, MK. [et al] (2015). The influence of primary care quality on hospital admissions for people with dementia in England: a regression analysis. PloS One, March 27th 2015, Vol.10(3), e0121506. (Click here to view the PubMed abstract).
A BMJ article, possibly also of related interest, appeared recently:
Full Text Link (Note: This article requires a suitable Athens password, a journal subscription or payment for access).
Wallace, E. Smith, SM. [and] Fahey, T. [et al] (2016). Reducing emergency admissions through community based interventions. BMJ. January 28th 2016; 352: h6817.
Possibly also of interest:
Kar, N. (2015). Lack of community care facilities for older people and increased rate of admission and length of stay in hospitals. Journal of Geriatric Care and Research (JGCR). 2015, 2(2): pp.28-30.
The HOMEWARD Project
An investigation is underway to understand how older people living with dementia and other multi-morbidities actually use emergency ambulance services; and why these people are sometimes conveyed to A&E inappropriately when they could be treated better at home or in the community.
Voss, S. Black, S. [and] Brandling, J. [et al] (2017). Home or hospital for people with dementia and one or more other multimorbidities: what is the potential to reduce avoidable emergency admissions? The HOMEWARD Project Protocol. BMJ Open. April 3rd 2017; 7(4): e016651.
NIHR Research for Patient Benefit Programme
NIHR research has been conducted on the premise that consulting the opinions of older people themselves may help understand the reasons for avoidable emergency admissions and ensure they get appropriate care:
Glasby, J. Littlechild, R. [and] Le Mesurier, N. [et al] (2016). Who knows best? Older people’s contribution to understanding and preventing avoidable hospital admissions. Birmingham: University of Birmingham (Health Services Management Centre, Department of Social Policy and Social Work), 2016.