Table 1.
Subsequent emergency spells and deaths in 3 years of follow-up by factor relating to index spell in 2000/2001
| Factor | Patients admitted as an emergency in 2000/2001 | Patients who become highimpact users (%) | Subsequent spells per patient in first year | Subsequent spells per patient in second year | Subsequent spells per patient in third year | Death rate within 1 year (%) | Death rate within 2 years (%) | Death rate within 3 years (%) |
|---|---|---|---|---|---|---|---|---|
| Age | ||||||||
| All | 2 747 509 | 269 849 (9.8) | 0.46 | 0.27 | 0.23 | 8.8 | 13.2 | 16.8 |
| 0-4 | 277 413 | 20 700 (7.5) | 0.38 | 0.18 | 0.12 | 0.4 | 0.5 | 0.5 |
| 5-44 | 1 006 961 | 65 885 (6.5) | 0.33 | 0.20 | 0.18 | 0.8 | 1.3 | 1.7 |
| 45-64 | 518 500 | 53 265 (10.3) | 0.47 | 0.28 | 0.25 | 7.1 | 10.1 | 12.4 |
| 65-74 | 345 257 | 46 435 (13.4) | 0.60 | 0.36 | 0.31 | 14.9 | 21.8 | 27.4 |
| 75-84 | 384 195 | 54 794 (14.3) | 0.63 | 0.38 | 0.32 | 21.1 | 32.3 | 41.9 |
| 85+ | 215 183 | 28 770 (13.4) | 0.61 | 0.35 | 0.25 | 29.3 | 45.0 | 57.6 |
| Deprivation fifth | ||||||||
| 1 (least deprived) | 410 553 | 33 087 (8.1) | 0.39 | 0.21 | 0.17 | 9.6 | 14.2 | 17.9 |
| 2 | 465 972 | 41 423 (8.9) | 0.42 | 0.23 | 0.20 | 9.6 | 14.3 | 18.1 |
| 3 | 514 095 | 49 095 (9.5) | 0.45 | 0.26 | 0.21 | 9.3 | 14.0 | 17.8 |
| 4 | 581 732 | 59 790 (10.3) | 0.48 | 0.29 | 0.24 | 8.8 | 13.2 | 16.9 |
| 5 (most deprived) | 727 251 | 84 742 (11.7) | 0.54 | 0.33 | 0.28 | 7.9 | 12.0 | 15.4 |
| Unknown | 47 906 | 1 712 (3.6) | 0.18 | 0.10 | 0.08 | 3.1 | 4.5 | 5.7 |
| Spells in previous year | ||||||||
| 0 | 2 399 496 | 190 094 (7.9) | 0.38 | 0.22 | 0.19 | 7.7 | 11.7 | 15.0 |
| 1 | 237 500 | 41 454 (17.5) | 0.75 | 0.46 | 0.37 | 14.8 | 22.0 | 27.6 |
| 2 | 65 721 | 17 945 (27.3) | 1.13 | 0.68 | 0.53 | 18.2 | 26.9 | 33.4 |
| 3+ | 44 792 | 20 356 (45.4) | 2.21 | 1.34 | 0.99 | 20.3 | 29.4 | 36.0 |
| ACS condition | ||||||||
| COPD | 48 821 | 13 298 (27.2) | 1.16 | 0.75 | 0.59 | 22.7 | 36.2 | 46.9 |
| Diabetes with complications | 10 479 | 2 338 (22.3) | 0.98 | 0.69 | 0.61 | 9.3 | 15.5 | 20.6 |
| Congestive heart failure | 36, 22 | 7 559 (20.6) | 0.87 | 0.46 | 0.33 | 29.5 | 43.9 | 54.7 |
| Angina (without major procedure) | 62 012 | 10 462 (16.9) | 0.74 | 0.49 | 0.44 | 7.3 | 12.5 | 17.5 |
| Convulsions and epilepsy | 39 526 | 5 728 (14.5) | 0.66 | 0.42 | 0.34 | 5.1 | 8.4 | 11.1 |
| Gangrene | 2 239 | 301 (13.4) | 0.62 | 0.31 | 0.25 | 25.9 | 35.5 | 44.1 |
| Iron-deficiency anaemia | 5 727 | 738 (12.9) | 0.58 | 0.36 | 0.29 | 17.3 | 27.2 | 35.4 |
| Asthma | 42 969 | 4 804 (11.2) | 0.53 | 0.38 | 0.33 | 1.8 | 3.2 | 4.5 |
| Vaccine-preventable conditions | 1 644 | 179 (10.9) | 0.50 | 0.25 | 0.25 | 5.2 | 7.0 | 8.3 |
| Flu and pneumonia (42 months old) | 27 405 | 2 843 (10.4) | 0.49 | 0.28 | 0.24 | 13.6 | 20.6 | 26.1 |
| Non-ACS | 2 324 215 | 211 759 (9.1) | 0.43 | 0.25 | 0.21 | 8.6 | 12.8 | 16.2 |
| Dehydration and gastroenteritis | 35 045 | 2 818 (8.0) | 0.39 | 0.23 | 0.20 | 7.9 | 11.4 | 14.4 |
| Hypertension | 4 443 | 327 (7.4) | 0.36 | 0.26 | 0.24 | 4.9 | 8.9 | 13.4 |
| Cellulitis (without major procedure) | 30 636 | 2 219 (7.2) | 0.36 | 0.24 | 0.22 | 6.4 | 11.0 | 15.3 |
| Pelvic inflammatory disease | 4 756 | 338 (7.1) | 0.34 | 0.24 | 0.21 | 0.5 | 0.8 | 1.0 |
| Perforated/bleeding ulcer | 5 808 | 384 (6.6) | 0.35 | 0.21 | 0.19 | 10.3 | 16.5 | 22.2 |
| Ear, nose and throat infections | 54 355 | 3 270 (6.0) | 0.31 | 0.16 | 0.12 | 0.6 | 0.9 | 1.2 |
| Pyelonephritis | 6 106 | 355 (5.8) | 0.30 | 0.20 | 0.19 | 1.6 | 2.4 | 3.5 |
| Nutritional deficiencies | 35 | 2 (5.7) | 0.29 | 0.17 | 0.09 | 14.3 | 22.9 | 34.3 |
| Dental conditions | 4 666 | 127 (2.7) | 0.17 | 0.13 | 0.12 | 2.3 | 3.5 | 4.6 |
ACS, ambulatory care sensitive (those considered most amenable to case management); COPD, chronic obstructive pulmonary disease