Mapping emergency admissions of older adults with multimorbidity
Journeys to hospital. An in-depth exploration of primary care’s role in the emergency admission of older people with multimorbidity
University of Leicester
Duration of Study in the UK
2 years, 0 months, 30 days
Multimorbidity is the presence of more than one chronic disease. People with multimorbidity are more likely to experience an emergency admission to hospital. These admissions are expensive and can be distressing for patients and their carers. However, despite efforts to reduce emergency admissions, rates continue to increase, creating growing pressure on health system resources. A proportion of these admissions could be prevented or better managed in the community.
To understand the primary care factors associated with an emergency hospital admission for these people between 2 and 6 patients with multimorbidity and a recent emergency admission by their GP will be invited from each of up to six practices to participate in a qualitative study to map the patient's 'journey' from home to hospital.
Patient case records will be reviewed and those with a potentially avoidable admission will be invited for an interview. A visual map of each patient's journey will be drawn to document the series of steps occurring before admission. This will identify key events before admission and highlight individuals involved in the decision to admit them to hospital.
A carer will also be invited for interview as well as the admitting GP. For patients who lack capacity to consent we will approach the GP to nominate a consultee. Short periods of observation at the patient’s GP surgery and interviews with Practice Managers about the surgery’s approach to emergency admissions in older adults will be conducted.
Observational, interview and mapping data will be analysed to look for recurring themes to further explain the primary care factors associated with emergency admissions. Results of this study will aim to provide useful information for local policy makers and also inform the development of an intervention that could be used to reduce avoidable emergency admissions for patients with multimorbidity.
Wales REC 7
Date of REC Opinion
17 Aug 2017
Further Information Favourable Opinion