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Social care budget cuts likely to increase hospital admissions

GP supervision in care homes reduces need for hospital care, says study

Adrian O'Dowd

Friday, 30 March 2012

Hospital admissions are likely to rise sharply if proposed cuts to social care funding go ahead, warns a new report published in the Journal of Health Services Research and Policy.

The report by health think tank the Nuffield Trust found that local authority funded care home residents had fewer hospital admissions than those receiving high intensity social care support in their own homes.

The report’s authors linked the normally separate health and social care records of 133,055 people aged 75 and over.

This is believed to be the largest study of its kind in the UK so far, allowing researchers to examine interactions between the two systems of care at the individual patient level. Records for a single year (2006-2007) were extracted from the operational information systems of four PCT areas and their corresponding local authority areas.

Results showed that 14% of older people received local authority-funded social care in one year, 59% accessed NHS hospital care and 10% accessed both types of service. Most people using social care also used a hospital service (71%). This was a higher proportion than for people who did not use social care services (57%).

However, analysis of hospital usage according to the type of social care revealed a more complex picture – 58% of care home residents were admitted to hospital, which was a lower proportion than the group receiving high-intensity support in their own homes, of which 73% were admitted.

When the figures were broken down further it was found that the care home group also had fewer outpatient attendances than those receiving care in their own homes – lower than even the people who received no social care at all.

The authors said a possible explanation for these patterns was that care homes were effective in avoiding the need for hospital care, thanks to more intensive GP supervision, or in reducing the risks of falls.

Another explanation was that care home staff could be in a better position to support people and manage their health problems in ways that did not require a trip to the hospital.

However, the reason for the pattern could be down to problems accessing hospital care for some people living in care homes.

The results, said the authors, lent further support to the argument that cuts to social care budgets may lead to increased hospital admissions.

Dr Martin Bardsley, Nuffield Trust head of research and lead investigator on the study, said: “The significance of these observations is twofold. Firstly that reduction in social care budgets and access to care homes may put pressure on hospitals.

“Secondly, that we ought to be looking to use these data to understand something more about what constitutes good quality social care, and see if we can use information about the management of health problems, to help spot the difference between good and bad social care.”

Dr Jennifer Dixon, Director of the Nuffield Trust, added: “Further research is needed to understand the causes behind these phenomena but the results emphasise once again that changes in social care can have knock on effects in the NHS.”

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