Emergency readmissions – where patients are readmitted to hospital in an emergency within 30 days of discharge – are frequently used as a measure of poor patient outcomes. However, it is not that simple. Some emergency readmissions may result from potentially avoidable adverse events, but others may be due to unrelated or unforeseen causes of admission. Some may relate to changes in the way that hospitals run services – for example, through the increased use of frailty and ambulatory care units. And others might be a consequence of our ageing population and the increase in the number of people living with multiple chronic conditions.
Despite the complications in interpreting what this means for the quality of care, publishing data on emergency readmissions is the first step in understanding why they are happening. Last year, we published a briefing using Hospital Episode Statistics data to look at trends in emergency readmissions to hospital, at a time when no data was being published. In March 2019, NHS Digital published data on emergency readmissions as part of their review, and it is this data which is presented here.
Between 2013/14 and 2017/18, the number of 30-day emergency readmissions to hospital in England increased by 15%, from 758,955 to 869,155. The total number of emergency admissions increased by 4% over the same time period, from 6,114,080 to 6,528,335 (data not shown). This results in an increase in the emergency readmissions rate, from 12.4% in 2013/14 to 13.7% in 2017/18.
This analysis did not use risk adjustment (an analytical technique to take account of differences in the characteristics of a population which may impact on the risk of an event). As such, changes in readmission rates over time may reflect differences in the patient population, with more severely ill and older patients being more likely to be readmitted. A recent study showed that when you take account of this via risk adjustment, the rate of readmissions is broadly stable, so quality of care seems to have been maintained.
However, while this aspect of quality has not deteriorated, it does not appear to have improved either, so there remains a potential opportunity to target improvement efforts by focusing on potentially preventable readmissions.
About this data
This indicator measures the percentage of emergency admissions to any hospital in England occurring within 30 days of the most recent discharge from hospital. Admissions for cancer and obstetrics are excluded as they may be part of the patient’s care plan. For more information, please see NHS Digital’s Indicator specification.