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Analysis of trends in emergency and elective hospital admissions and hospital bed days 1997 to 2015

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  • Redding, Stuart
  • Nicodemo, Catia
  • Wittenberg, Raphael

Abstract

Despite the concerns and efforts of policy makers, it has proved difficult to restrain the growth in hospital admissions in England. Using data from Hospital Episode Statistics (HES), in this paper we perform, for all patients treated in English hospitals between 1997/8 and 2014/15, an age, period, cohort (APC) analysis to examine how far trends in emergency and elective hospital admissions and bed days can be explained by: the effects of the age distribution of the population, together with rising numbers of older people; cohort effects due to differing admission rates of people born in different years, and period effects, effects relating to a specific year which cannot be explained by either age or cohort effects. This time period was chosen to cover a time of significant policy upheaval in the NHS, including significant reforms to the ways in which hospitals were funded, managed and had patients referred to them. We find that most of the increase in elective admissions is due to the period effect. Elective bed-days have been decreasing, generally due to a shift towards day-cases. Emergency bed-day rates have remained consistent, with the effects of an ageing population being counteracted by increasingly healthy cohorts. These results suggest that demographic factors are not the primary drivers of growth in hospital use and that there may be a role for well-designed policy to influence the current trends.

Suggested Citation

  • Redding, Stuart & Nicodemo, Catia & Wittenberg, Raphael, 2021. "Analysis of trends in emergency and elective hospital admissions and hospital bed days 1997 to 2015," Social Science & Medicine, Elsevier, vol. 279(C).
    • Handle: RePEc:eee:socmed:v:279:y:2021:i:c:s0277953621003348
    DOI: 10.1016/j.socscimed.2021.114002
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    References listed on IDEAS

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    1. Reither, Eric N. & Masters, Ryan K. & Yang, Yang Claire & Powers, Daniel A. & Zheng, Hui & Land, Kenneth C., 2015. "Should age-period-cohort studies return to the methodologies of the 1970s?," Social Science & Medicine, Elsevier, vol. 128(C), pages 356-365.
    2. Nigel Rice & Maria Jose Aragon, 2018. "The determinants of health care expenditure growth," Working Papers 156cherp, Centre for Health Economics, University of York.
    3. Wittenberg, Raphael & Sharpin, Luke & McCormick, Barry & Hurst, Jeremy, 2017. "The ageing society and emergency hospital admissions," Health Policy, Elsevier, vol. 121(8), pages 923-928.
    4. Coast, J. & Smith, R. D. & Millar, M. R., 1998. "An economic perspective on policy to reduce antimicrobial resistance," Social Science & Medicine, Elsevier, vol. 46(1), pages 29-38, January.
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    Cited by:

    1. Forchini, Giovanni & Hauck, Katharina & Steventon, Adam, 2020. "Seasonal and regional fluctuations in the demand for Accident and Emergency care in English hospitals," Umeå Economic Studies 970, Umeå University, Department of Economics.

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