Understanding the distribution of A&E attendances and hospital admissions for the case managed population: A single case cross sectional study.

AIM: To describe the characteristics of case-managed patients presenting at accident and emergency (A & E) and to explore the distribution of their attendances and admissions.

BACKGROUND: Recently, the UK Government announced extended-hours primary care provision in an effort to reduce the growing utilization of A & E. No evidence is available to understand the use of acute services by this high-risk patient group.

METHOD: A cross-sectional design utilising routinely collected anonymsed A & E attendance and hospital admission data from 2010 to 2015.

RESULTS: The case-managed population is typically 70years and older and most often arrive at A & E via emergency services and during the night (00:00-08:59). A large proportion are subsequently admitted having a statistically significant A & E conversion rate. No variables were predictive of admission.

CONCLUSION: The high level of A&E conversion could indicate case-managed patients are presenting appropriately with acute clinical need. However, inadequate provision in primary-care could drive decisions for admitting vulnerable patients.