Rise in hospital admissions for older people

Thursday 8th August 2019

The number of admissions to geriatric wards in Scotland’s hospitals has risen by 10% for three consecutive years, according to a new report.

The survey of the country’s 19 largest hospitals, carried out by the University of Aberdeen, revealed there were 43,311 admissions in 2017/18, compared to 32,009 in 2014/15.

The length of stay fell by an average of one day over that time – but there was huge variation across hospitals, ranging from three days in Aberdeen Royal Infirmary to 36 days at Perth Royal Infirmary.

Researchers said delays in accessing specialist services could lead to longer stays in hospital, with a link between the time waiting for a specialist bed and the total length of stay.

The survey also found wide variations in changes in activity over the last three years, ranging from a 41% drop in University Hospital Ayr to an 84% increase in Borders General Hospital.

It is the first acute hospitals report to NHS Boards and health and social care partnerships by the Scottish Care of Older People (SCoOP) initiative, which was set up in 2016 by Healthcare Improvement Scotland, the British Geriatrics Society, and the University of Aberdeen.

Professor Phyo Myint, clinical chair in medicine of old age at the University of Aberdeen and SCoOP Steering Group co-chair, said: “The report highlights significant variation in outcomes across the country and provides potential benchmarks for future quality improvement and greater consistency in outcomes.”

Overall, mortality rates have remained ‘fairly steady’ since 2013, averaging at around 16.5% at 30 days after admission, with readmission rates also remaining broadly stable over the last three years.

Dr Roy Soiza, working group member of the report and consultant physician at NHS Grampian, says there are many factors that can account for variation in outcomes – such as differences in types of cases, the way services are set up, resources and staffing.

He said: “The report does not attempt to explain the variation but aims to stimulate thoughtful discussion, learning and action and should be used to help benchmark some key patient outcomes and inspire a culture of interorganisational learning and continuous improvement.”

Professor Graham Ellis, co-chair of SCoOP Steering Group and the national clinical lead for older people, Healthcare Improvement Scotland, added: “The wider goal is to reduce unwarranted and unjustifiable variation in outcomes, which may represent a threat to patient safety and/or a failure to learn from best practice.”