New evidence suggests that alternatives to acute hospital admissions for older people are safe and can reduce hospital use

Research published in BMJ Open has found that alternatives to acute hospital admissions for older people appear safe and could reduce both the number and duration of acute hospital stays.

The study, funded by the National Health Institute for Research and led by Professor Sarah Purdy at the University of Bristol's Centre for Academic Primary Care, identified and appraised alternatives to acute hospital care for people over the age of 65.

The systematic review looked at 19 randomised and non-randomised controlled studies and seven previous reviews. The studies included patients with specific conditions such as heart failure or chronic obstructive pulmonary disease, as well as mixed chronic and acute conditions such as elderly frail patients with pneumonia.

The study identified four main types of acute hospital alternatives for patients:

· paramedic intervention

· intervention in A&E departments

· care in a community hospital

· ‘hospital-at home’ services

The evidence suggests that these alternatives to hospital admission appear safe with potential to reduce acute hospital care use and length of time patients need to receive care. For example, older patients with heart failure treated through a 'hospital-at-home' service saw the time period between hospital admissions increase significantly – without any increased risk in mortality - compared to similar patients who were routinely admitted.