Improving care in the community for people with conditions such as diabetes would lead to fewer hospital admissions, according to new research.
A study by the University of Bristol’s School of Social and Community Medicine reveals hospital admission rates are 55 per cent higher in some parts of the UK. Conditions such as diabetes, alcoholism and dementia as well as social deprivation are shown to cause the increase.
Dr John Busby, lead author of the study, published in The British Journal of General Practice, said: “Admission rates for some of the conditions in our study, including alcoholism, schizophrenia and diabetes, were over three times higher in some practices than others.
“Clearly, this raises important questions about why these differences exist and what can be done to standardise care around best practice.”
Researchers investigated hospital admission variations between the 8,000 general practices in England during 2011/12 including 1.8 million admissions.
It is thought that admissions rates could be reduced if GPs received more support to provide more specialist care for those groups at higher risk of being referred for hospital care.
Researchers working on the study applied the same methods to a broad range of conditions, including diabetes, schizophrenia, hypertensio, strokes and hip fractures. Researchers were then able to use the data to help identify which conditions the NHS could target in order to improve care and reduce admissions.
Dr Busby added: “Substantial differences in admission rates among general practices could mean that some patients are receiving suboptimal care.
“Our research suggests that differences in the way GP care is delivered across England could have an important impact on patient health. This could include sub-optimal management of chronic disease which puts patients at higher risk of hospital admissio, but also overly-cautious referrals to hospital, or a lack of alternatives to treat patients in the community.
“Clearly this matters to patients as most would prefer not to be admitted to hospital if it can be avoided, but it is also extremely important to the NHS finances as unplanned hospital admissions are expensive and can disrupt other care.”
“Existing mechanisms, such as the quality and outcomes framework and NICE guidelines, aim to ensure that patients receive a consistent quality of primary care across all practices in England.
The results are now being used to look into the reasons why such variations exist between GP practices and how those reasons can be used to improve care.
A follow-up investigation is planned to assess how the factors of a general practice are related to admission rates. This includes issues such as how easy it is to see a GP, the distance to the nearest A&E, how often patients can see their preferred GPs, and how many hospital beds are available locally.

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