Tackling 'frequent flyers' won't solve the rising emergency hospital admissions problem

September 18, 2012

Patients who are regularly admitted to hospital as emergencies (known as 'frequent flyers') make up a large proportion of admissions, but focusing just on them won't solve the problem of rising admissions, say experts in the British Medical Journal today.

Martin Roland and Gary Abel from the Cambridge Centre for Health Services Research argue that this is one of several about emergency admissions that must be tackled if we are to reduce the number of people being admitted as emergencies. Around the world, the pressure to reduce is huge. Emergency are an expensive aspect of care and rates have been rising for several years, particularly among the elderly and those with several conditions (co-morbidities).

In the UK, many initiatives have been set up to reduce emergency admissions, mainly in primary care and with a focus on high who are thought to use a disproportionate share of resources.

But Roland and Abel argue that there are "some fundamental flaws" in this approach. Exclusively focusing on high risk patients won't solve the problem, they say, as data show that most admissions come from low and medium risk groups. Instead they suggest interventions may need to be targeted on larger , such as .

They also challenge the widespread view that improving primary care could prevent many emergency admissions and suggest that some of the rise in admissions may be due to the introduction of four hour waiting targets in A&E. They say that primary and secondary care doctors need to work together to achieve a common set of goals.

They also point to the problem of "supply induced demand" for services which could explain the apparent increase in admissions found in some studies of intensive case management (e.g. community matrons).

Apart from a few exceptions, evaluations of interventions to reduce emergency admissions have been disappointing. Evaluations need to be evidence based, they need to allow for admission rates for individual patients falling of their own accord (a phenomenon known as regression to the mean) and to take account of variation due to chance. The authors suggest some guidelines for those needing to focus on this important and expensive aspect of healthcare

Explore further: Patients who see preferred doctor less likely to go for emergency hospital admission

Related Stories

Patients who see preferred doctor less likely to go for emergency hospital admission

May 17, 2011
A new study led by the University of Leicester has concluded that being able to see the GP of your choice in a doctor's surgery helps to reduce emergency hospital admissions.

Allowing patient access to chosen GP would reduce costs for the NHS

April 19, 2012
A University of Leicester study has provided clear evidence that allowing a patient to see a particular doctor in the GP surgery has an important impact on reducing hospital admissions.

Study identifies the most effective methods for reducing unplanned hospital admissions

July 11, 2012
Unplanned admissions make up approximately 40 per cent of hospital admissions in England and can increase problems for health services as they are costly, disruptive, and lengthen waiting lists. New research, published today ...

Counting the cost of cold winters: Emergency treatment for falls on snow and ice

June 17, 2011
During the winter of 2009-2010 the average temperature for the UK was 1.6 degrees centigrade (°C), making it the coldest recorded winter in the last 30 years. Using winter data from 2005 to 2010, new research published ...

Recommended for you

Sugar not so sweet for mental health

July 27, 2017
Sugar may be bad not only for your teeth and your waistline, but also your mental health, claimed a study Thursday that was met with scepticism by other experts.

Could insufficient sleep be adding centimeters to your waistline?

July 27, 2017
Adults in the UK who have poor sleep patterns are more likely to be overweight and obese and have poorer metabolic health, according to a new study.

Vitamin E-deficient embryos are cognitively impaired even after diet improves

July 27, 2017
Zebrafish deficient in vitamin E produce offspring beset by behavioral impairment and metabolic problems, new research at Oregon State University shows.

The role of dosage in assessing risk of hormone therapy for menopause

July 27, 2017
When it comes to assessing the risk of estrogen therapy for menopause, how the therapy is delivered—taking a pill versus wearing a patch on one's skin—doesn't affect risk or benefit, researchers at UCLA and elsewhere ...

Blowing smoke? E-cigarettes might help smokers quit

July 26, 2017
People who used e-cigarettes were more likely to kick the habit than those who didn't, a new study found.

Brain disease seen in most football players in large report

July 25, 2017
Research on 202 former football players found evidence of a brain disease linked to repeated head blows in nearly all of them, from athletes in the National Football League, college and even high school.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.