Emergency hospital admissions in patients from care home settings


The project aims to develop clinical tools to help healthcare professionals identify when people living in care homes need to come into hospital if they become suddenly unwell, and when they could be safely cared for in their homes.


Nearly 340,000 older people in England live in residential or nursing care homes, often with complex health problems, which make them more likely to need hospital care if their health suddenly deteriorates. People living in care homes account for 185,000 emergency admissions to hospital each year. In total, this adds up to over 1.46 million days spent in hospital.

Evidence suggests that a significant proportion of hospital admissions of older people living in care homes are unnecessary and could be avoided if their health needs were addressed differently. This is important. Hospital admissions are associated with complications in older people, including falls, hospital-acquired infections and a loss of physical fitness. Also, hospital beds are always in demand, needed for planned operations and treatments, including cancer treatments.

These unnecessary admissions have driven research into alternative ways of caring for older care home residents when they are acutely unwell.


By using PIONEER data, the researcher wishes to identify the reasons for emergency admissions in older patients, the care they needed in hospital and explore if this care could have been delivered in the care home.

Using this data, the research team will develop tools which can predict whether care can be provided in the person’s home or whether hospital transfer is needed. The development of predictive models will help services to be more responsive to anticipated demand, ensuring that maximum patient impact can be achieved.


The project has been discussed with older people admitted to hospital from care homes and their relatives. Their input ensured the outcomes of the project would be meaningful.

The researchers intend to continue their engagement via the Patient Participation Team based at the University Hospitals Birmingham NHS Foundation Trust as well as the University of Birmingham.

They will engage with the West Midlands Applied Research Collaboration (ARC) through their acute/social care patient group.


This project was supported unanimously by the PIONEER Data Trust Committee.

The work is led by Dr Thomas Knight, Clinical Research Fellow at the University of Birmingham.

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