Interventions to reduce unplanned hospital admission: a systematic review

Approximately 40% of hospital admissions in England are unplanned admissions (2009/10). Unplanned hospital admissions (UHA) are a problem for health systems internationally as they are costly and disruptive to elective health care, and increase waiting lists. Recent policy in the UK and elsewhere has focused on reducing UHA.

To reduce the burden on elective health care and resource use in the long term, it is therefore important to manage UHA. In order to do this we need to fully understand which interventions are effective in reducing UHA. There have been a small number of community or societal level public health or policy interventions aimed at reducing UHA. These approaches have been variable and generally inconclusive.

Therefore there was a need for a series of comprehensive systematic literature reviews that would identify interventions that address organisation of care and access for the purpose of reducing UHA. The overall aim of this series of systematic reviews was to evaluate the effectiveness and costeffectiveness of interventions to reduce UHA. Our primary outcome measures of interest were reduction in risk of unplanned admission or readmission to a secondary care acute hospital, for any speciality or condition. We planned to look at all controlled studies namely randomised trials (RCTs), controlled clinical trials, controlled before and after studies and interrupted time series. If applicable, we planned to look at the cost effectiveness of these interventions.

A report of the research findings is available at:

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