Transcript chain.ulcc.ac.uk

Reducing Hospital Admissions
Using Health Forecasting
Neil Bewley
© Crown copyright 2007
27th March 2008
Page 1
Why did we start Health Forecasting?
The UK has the highest additional mortality for every degree below 18C
1.4
1.2
1.0
0.8
0.6
0.4
0.2
0
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Extra winter mortality
% increase in mortality for each 1ºC fall from 18ºC
Keatinge et al, 1997
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COPD Health Forecasting
COPD Health Forecasting is about …
…identifying who is at risk and forecasting
when and where they are at risk …
… and using this information to administer
anticipatory care to help keep people with
COPD well.
© Crown copyright 2007
Page 3
The Effect of Cold on Hospital Admissions
COPD admissions 10- 12 day lag
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Page 4
Identifying risk by person...
‘Low risk’ patients make up 70% of admissions during winter, and 90%
of week-on-week variation
Low risk patients
(no previous
admissions for COPD)
Moderate risk patients
(admitted 1-2 times in
past 12 months)
High risk patients
(admitted more than
3 times in past 12
months)
© Crown copyright 2007
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Identifying risk by person...
Over a typical winter in a typical practice most admissions
are from low risk patients
Patients
List size
Admissions
10,415
COPD register
112
No admission group
99
6
1-3 previous admissions
6
1
3 or more admissions
7
2
Based on National Tariff for COPD admission without complications
© Crown copyright 2007
Page 6
Results of staff feedback March 2006
Making calls in person takes up too much time
We don’t have the resources to make all the
calls
We are unable to make contact by telephone
as not all patients are not in during surgery
opening hours
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How the system works
Met Office Forecaster
Health
Forecasts
NHS Network
Call logs
Patient name and
tel no, changes to
patient status
GP practice
Monitoring
Medixine software
on NHS Server
Telephone
numbers
Medixine
administrator
Patient
responses
Automated
telephone call
Person with
COPD
© Crown copyright 2007
Patient
responses
Medixine
interactive voice
response system
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Review of Cornwall automated service pilot
Comparison of hospital admissions
6.00
12%
Admissions per 100 COPD patients
5.00
52%
4.00
3.00
2005/06
2005/06
2.00
2006/07
1.00
2006/07
-
Practices using Health Forecasting
© Crown copyright 2007
Practices not using Health Forecasting
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Patient Perception
345 completed questionnaires
How helpful were calls?
89% said calls were helpful (62% very, 27% fairly)
11% said calls were not helpful (7% not, 4% not at all)
Actions in response to call
30% consulted patient pack
19% consulted their doctor
53% obtained a repeat prescription
© Crown copyright 2007
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Staff feedback March 07
Stress free! All automatic
Much less work than anticipated especially
with follow up calls
Takes onus off surgery to check up on all
patients and lets us concentrate on more
severe patients
Cost effective
Good system and easy to use
© Crown copyright 2007
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Summary of service
Successful service pilot with 445 patients
involved
Helped reduce COPD hospital admissions by
delivering a forecast direct to those who need it
Delivers real benefit by helping keep people
well
Cost effective - generating cost savings up to
3.5 times greater than the projected costs
© Crown copyright 2007
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This winter
We are providing the automated service to 8
PCTs across England, Wales and Scotland with
7,410 calls made on 29th January, 58% of
patients responded, 30% of those indicated
worsening symptoms, lack of medication or
both!
Cornwall expanded service to over 40 practices
this winter 1856 calls on 29th Jan, 64%
responded, 28% of these indicated symptoms
or lack of medication.
Results of admission reductions from the PCTs
taking part due May 2008.
© Crown copyright 2007
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How to get involved
Speak to us today to understand how you
could benefit from the service.
Call me, Neil Bewley on 01392 886736
E-mail: [email protected]
See our saving benefit calculator at
http://www.metoffice.gov.uk/health
© Crown copyright 2007
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