Could the rise in mortality rates since 2015 be explained by changes in the number of delayed discharges of NHS patients?

Green, M. A., Dorling, D., Minton, J. and Pickett, K. E. (2017) Could the rise in mortality rates since 2015 be explained by changes in the number of delayed discharges of NHS patients? Journal of Epidemiology and Community Health, 71(11), pp. 1068-1071. (doi: 10.1136/jech-2017-209403) (PMID:28970194)

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Abstract

Background: 2015 saw the largest annual spike of mortality rates in England in almost 50 years. We examine whether these changes in mortality rates are associated with an indicator of poor functioning of health and social care: delay in hospital discharges. Methods: Office for National Statistics monthly data of death counts and mortality rates for the period August 2010–March 2016 were compared with delays in discharges from National Health Service (NHS) England data on transfers of care for acute and non-acute patients in England. Autoregressive Integrated Moving Average regression models were used in the analysis. Results: We estimate that each additional day an acute admission was late being discharged was associated with an increase in 0.394 deaths (95% CIs 0.220 to 0.569). For each additional acute patient delayed being discharged, we found an increase of 7.322 deaths (95% CIs 1.754 to 12.890). Findings for non-acute admissions were mixed. Conclusion: The increased prevalence of patients being delayed in discharge from hospital in 2015 was associated with increases in mortality, accounting for up to a fifth of mortality increases. Our study provides evidence that a lower quality of performance of the NHS and adult social care as a result of austerity may be having an adverse impact on population health.

Item Type:Articles
Keywords:NHS, austerity, health care, mortality.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Minton, Dr Jonathan
Authors: Green, M. A., Dorling, D., Minton, J., and Pickett, K. E.
College/School:College of Social Sciences > School of Social and Political Sciences > Urban Studies
Journal Name:Journal of Epidemiology and Community Health
Publisher:BMJ Publishing Group
ISSN:0143-005X
ISSN (Online):1470-2738
Published Online:16 October 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in Journal of Epidemiology and Community Health 71(11): 1068-1071
Publisher Policy:Reproduced under a Creative Commons License

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