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Title: Identifying patient-level health and social care costs for older adults discharged from acute medical units in England
Authors: Franklin, M.
Berdunov, V.
Edmans, J.
Conroy, Simon
Gladman, J.
Tanajewski, L.
Gkountouras, G.
Elliott, R. A.
First Published: 24-Jul-2014
Publisher: Oxford University Press (OUP)
Citation: Age Ageing, 2014, 43 (5), pp. 703-707
Abstract: BACKGROUND: acute medical units allow for those who need admission to be correctly identified, and for those who could be managed in ambulatory settings to be discharged. However, re-admission rates for older people following discharge from acute medical units are high and may be associated with substantial health and social care costs. OBJECTIVE: identifying patient-level health and social care costs for older people discharged from acute medical units in England. DESIGN: a prospective cohort study of health and social care resource use. SETTING: an acute medical unit in Nottingham, England. PARTICIPANTS: four hundred and fifty-six people aged over 70 who were discharged from an acute medical unit within 72 h of admission. METHODS: hospitalisation and social care data were collected for 3 months post-recruitment. In Nottingham, further approvals were gained to obtain data from general practices, ambulance services, intermediate care and mental healthcare. Resource use was combined with national unit costs. RESULTS: costs from all sectors were available for 250 participants. The mean (95% CI, median, range) total cost was £1926 (1579-2383, 659, 0-23,612). Contribution was: secondary care (76.1%), primary care (10.9%), ambulance service (0.7%), intermediate care (0.2%), mental healthcare (2.1%) and social care (10.0%). The costliest 10% of participants accounted for 50% of the cost. CONCLUSIONS: this study highlights the costs accrued by older people discharged from acute medical units (AMUs): they are mainly (76%) in secondary care and half of all costs were incurred by a minority of participants (10%).
DOI Link: 10.1093/ageing/afu073
ISSN: 0002-0729
eISSN: 1468-2834
Version: Post-print
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: This is a pre-copyedited, author-produced PDF of an article accepted for publication in Age and Ageing following peer review. The version of record Age Ageing (2014) 43 (5): 703-707 is available online at:
Appears in Collections:Published Articles, Dept. of Health Sciences

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