Hospital admissions from care homes in England during the COVID-19 pandemic: a retrospective, cross-sectional analysis using linked administrative data

Grimm, Fiona; Hodgson, Karen; Brine, Richard; Deeny, Sarah R

doi:10.23889/ijpds.v5i4.1663

Cited by 15 publications

(17 citation statements)

References 27 publications

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“…Admissions from own home made up 71.1%, and admissions from care homes 20.8% of admissions. Between 20 January 2020 and 28 June 2020 the rate of emergency admissions to hospital for residential and nursing home residents in England decreased by 36% and 38% respectively [28]. This has been attributed to government policy; primary care and community health services were asked to support care homes with the aim to reduce admissions to hospital [29].…”

Section: Discussionmentioning

confidence: 99%

The Cause and Duration of Emergency Admissions to Hospital in People with Idiopathic Parkinson’s Disease, Under the Care of a UK Service, During the First Year of the COVID-19 Pandemic

Ellis

Davies

Gray

et al. 2022

JPD

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Background: People with Parkinson’s disease (PD) have higher rates of hospitalisation and healthcare utilisation compared to the general population. The COVID-19 pandemic caused significant changes in admissions to hospital and access to healthcare. People with PD are some of the most vulnerable to such changes. There is no pre-existing data on the cause and duration of admission to hospital of people with PD during the COVID-19 pandemic. Objective: To determine the cause, duration, and outcome of hospital admissions to Northumbria Healthcare NHS Foundation Trust (NHCFT) for people with idiopathic Parkinson’s disease (IPD) in 2020. Methods: All people with IPD who had an emergency admission to NHCFT between 01/01/2020 and 31/12/2020 were identified. Demographic and disease characteristics, the number, duration, cause of admission and the location prior to admission were collected from an audit of medical notes. Results: 271 people with IPD had one or more emergency admissions to NHCFT between 01/01/2020 and 31/12/2020. There was a total of 453 emergency admissions, with a median duration of 5 (IQR 2-13) days. The most common causes of admission to hospital were PD-related motor dysfunction (includes falls with no other underlying cause or associated injury) and injury (includes falls with fracture), at 78 (17.2%) and 70 (15.5%) respectively. Conclusions: People with IPD had a short duration but high number of emergency admissions to hospital. Our chronological data on number of admissions shows a peak in admissions during August 2020. As a result of these findings and emerging data we suggest that individuals with PD deconditioned during 2020.

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Section: Discussionmentioning

confidence: 99%

The Cause and Duration of Emergency Admissions to Hospital in People with Idiopathic Parkinson’s Disease, Under the Care of a UK Service, During the First Year of the COVID-19 Pandemic

Ellis

Davies

Gray

et al. 2022

JPD

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“…1 2 An exception were admissions for falls and fragility fractures, which continued to present at similar rates and were managed as a surgical priority. [2][3][4][5][6][7] Hip fracture is a major cause of accidental disability and…”

Section: Introductionmentioning

confidence: 99%

Indirect effect of the COVID-19 pandemic on hospital mortality in patients with hip fracture: a competing risk survival analysis using linked administrative data

et al. 2022

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BackgroundHip fracture is a leading cause of disability and mortality among older people. During the COVID-19 pandemic, orthopaedic care pathways in the National Health Service in England were restructured to manage pressures on hospital capacity. We examined the indirect consequences of the pandemic for hospital mortality among older patients with hip fracture, admitted from care homes or the community.MethodsRetrospective analysis of linked care home and hospital inpatient data for patients with hip fracture aged 65 years and over admitted to hospitals in England during the first year of the pandemic (1 March 2020 to 28 February 2021) or during the previous year. We performed survival analysis, adjusting for case mix and COVID-19 infection, and considered live discharge as a competing risk. We present cause-specific hazard ratios (HRCS) for the effect of admission year on hospital mortality risk.ResultsDuring the first year of the pandemic, there were 55 648 hip fracture admissions: a 5.2% decrease on the previous year. 9.5% of patients had confirmed or suspected COVID-19. Hospital stays were substantially shorter (p<0.05), and there was a higher daily chance of discharge (HRCS 1.40, 95% CI 1.38 to 1.41). Overall hip fracture inpatient mortality increased (7.2% in 2020/2021 vs 6.4% in 2019/2020), but patients without concomitant COVID-19 infection had lower mortality rates compared with the year before (5.3%). Admission during the pandemic was associated with a 11% increase in the daily risk of hospital death for patients with hip fracture (HRCS 1.11, 95% CI 1.05 to 1.16).ConclusionsAlthough COVID-19 infections led to increases in hospital mortality, overall hospital mortality risk for older patients with hip fracture remained largely stable during the first year of the pandemic.

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“…The authors comment on page 10 that 1 st February 2020 may be sufficient for assessing first wave care home residency is less certain in view of the mass movement out of hospital which took place in March and into April. It may be better to acknowledge that this is simply an unknown limitation (as per other research in this period specifically relating to those living in care homes: Grimm et al , 2020 1 ).…”

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confidence: 97%

Identifying Care Home Residents in Electronic Health Records - An OpenSAFELY Short Data Report

et al. 2021

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Background: Care home residents have been severely affected by the COVID-19 pandemic. Electronic Health Records (EHR) hold significant potential for studying the healthcare needs of this vulnerable population; however, identifying care home residents in EHR is not straightforward. We describe and compare three different methods for identifying care home residents in the newly created OpenSAFELY-TPP data analytics platform. Methods: Working on behalf of NHS England, we identified individuals aged 65 years or older potentially living in a care home on the 1st of February 2020 using (1) a complex address linkage, in which cleaned GP registered addresses were matched to old age care home addresses using data from the Care and Quality Commission (CQC); (2) coded events in the EHR; (3) household identifiers, age and household size to identify households with more than 3 individuals aged 65 years or older as potential care home residents. Raw addresses were not available to the investigators. Results: Of 4,437,286 individuals aged 65 years or older, 2.27% were identified as potential care home residents using the complex address linkage, 1.96% using coded events, 3.13% using household size and age and 3.74% using either of these methods. 53,210 individuals (32.0% of all potential care home residents) were classified as care home residents using all three methods. Address linkage had the largest overlap with the other methods; 93.3% of individuals identified as care home residents using the address linkage were also identified as such using either coded events or household age and size. Conclusion: We have described the partial overlap between three methods for identifying care home residents in EHR, and provide detailed instructions for how to implement these in OpenSAFELY-TPP to support research into the impact of the COVID-19 pandemic on care home residents.

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Hospital admissions from care homes in England during the COVID-19 pandemic: a retrospective, cross-sectional analysis using linked administrative data

Cited by 15 publications

References 27 publications

The Cause and Duration of Emergency Admissions to Hospital in People with Idiopathic Parkinson’s Disease, Under the Care of a UK Service, During the First Year of the COVID-19 Pandemic

The Cause and Duration of Emergency Admissions to Hospital in People with Idiopathic Parkinson’s Disease, Under the Care of a UK Service, During the First Year of the COVID-19 Pandemic

Indirect effect of the COVID-19 pandemic on hospital mortality in patients with hip fracture: a competing risk survival analysis using linked administrative data

Identifying Care Home Residents in Electronic Health Records - An OpenSAFELY Short Data Report

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