GP supply, deprivation and emergency admission to hospital for COPD and diabetes complications in counties across Ireland: an exploratory analysis

Abstract

Geographical variation in rates of admission to hospital for chronic disease is associated with both population need and health system factors. These findings suggest that primary care resourcing must be a key consideration in any efforts to tackle acute hospital capacity problems.

Drivers of potentially avoidable emergency admissions in Ireland: an ecological analysis

“…Deprivation has been found to play a significant role in explaining the variation in standardised illness ratios13 and hospital admission rates 4 5 43. In the UK study, employment deprivation was found to account for 72% of the variation in potentially avoidable emergency admissions 5…”

“…Two principal studies were identified as the most appropriate for considering drivers of potentially avoidable emergency admissions in Ireland, one based in Ireland4 and one in the UK 5. A priori factors were chosen from these studies and other literature, and adapted for the Irish context (see table 1 and online supplementary appendix 2 for factor construction).…”

“…Potentially avoidable emergency admissions have been deemed indicative of health system performance 4–6. These admissions may occur due to an exacerbation from an underlying condition, in which case the admission may have been preventable if the appropriate management of the condition was observed.…”

“…For example, it has been proposed that the risk of emergency admission due to an exacerbation of asthma may be reduced if the condition is monitored by specialist nurses within the primary care system 5. An emergency admission may also be potentially avoidable if the patient could have been treated more appropriately elsewhere, such as in the patient’s home or in a community setting 4 5. The designation ‘potentially avoidable’ refers to a subset of total emergency admissions, and focuses on conditions which are assumed to be sensitive to the quality of primary care management and the availability of alternatives to hospitalisations 5…”

“…Service use in Ireland, regardless of condition, may also be driven by eligibility for medical card schemes 4. For example, the General Medical Services (GMS) card allows the use of the majority of health services free of charge, including doctor visits, all inpatient services to public wards in public hospitals and all outpatient services in public hospitals, as well as use of EDs, casualty and outpatient services 23 24.…”