Indicator update: people with 3 or more emergency admissions in the last 3 months of life, England 2015 to 2020
Published 5 July 2022
Applies to England
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This publication is available at https://www.gov.uk/government/statistics/palliative-and-end-of-life-care-profiles-july-2022-data-update/indicator-update-people-with-3-or-more-emergency-admissions-in-the-last-3-months-of-life-england-2015-to-2020
New in this update
This update includes new data for 3 indicators in the Palliative and End of Life Care Profiles (Hospital Care).
These are:
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percentage of deaths with 3 or more emergency admissions in the last 3 months of life – all ages
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percentage of deaths with 3 or more emergency admissions in the last 3 months of life – 75 years and older
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percentage of deaths with 3 or more emergency admissions in the last 3 months of life – under 75 years
Data should be interpreted in the context of the significant impact of coronavirus (COVID-19) on hospital admissions and mortality in 2020 and alongside the other indicators in the Palliative and End of Life Care tool.
The indicators, including all previous years, have been recalculated for the new 2021 clinical commissioning group (CCG) and 2020 sustainable transformation partnership (STP) configurations. Values therefore may not match those previously published.
Main findings
This update shows:
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in 2020 7% of people had 3 or more emergency admissions in the last 3 months of their life – this has significantly dropped by 1.2 percentage points from 8.2% in 2019
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the percentage of people with 3 or more emergency admissions in the last 3 months of life has continued to remain highest in the under 75 years age group
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due to the impact of the COVID-19 pandemic, caution should be taken when interpreting the data for 2020
Summary
This indicator is intended as an indicator of the quality of end of life care services and is not a direct measure of the quality of care at the individual level. The indicator is actively monitored by integrated care systems (ICS) and clinical commissioning groups (CCGs) that are encouraged to investigate when this measure is high, which could indicate:
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poor identification of people at risk of dying
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poor planning and/or availability of services to support people in the community
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poor communication, co-ordination and information sharing
In 2020, these indicators will have been affected by many factors, in particular the impact of the COVID-19 pandemic on admissions to hospital, changes in the way end of life care was delivered in the community and the increased number of people who died especially over the age of 75 years. Information and guidance on how to interpret these indicators can be found in the report, Emergency admissions in the 3 months before death.
In England in 2020 there was a significant reduction in the percentage of people who had 3 or more emergency admissions in the last 3 months of life. For all ages this was a reduction of 1.2 percentage points, from 8.2% in 2019 to 7.0% in 2020. For the under 75 age group this was a reduction of 1.7 percentage points, from 10.8% in 2019 to 9.1% in 2020. For the 75 and over age group this was a reduction of 1 percentage point, from 7.0% in 2019 to 6.0% in 2020.
Table 1 shows the total number of people who died as well as the number of people who had 3 or more emergency admissions in the last 3 months of life in 2019 and 2020. Although the number of people with 3 or more emergency admissions in the last 3 months of life was similar in 2019 and 2020, the overall number of people who died was greater in 2020. This affects the indicator values for this period.
Table 1: Total number of deaths, and number and percentage of people who had 3 or more emergency admissions in the last 3 months of life by age group (England, 2019 and 2020)
| Age group | Year | Total number of deaths | Number of deaths with 3 or more emergency admissions in last 3 months of life | Percentage of deaths with 3 or more emergency admissions in last 3 months of life |
|---|---|---|---|---|
| All ages | 2019 | 494,611 | 39,681 | 8.2 |
| All ages | 2020 | 568,070 | 40,371 | 7.0 |
| Under 75 | 2019 | 155,981 | 16,809 | 10.8 |
| Under 75 | 2020 | 175,970 | 16,003 | 9.1 |
| 75 and over | 2019 | 338,630 | 23,562 | 7.0 |
| 75 and over | 2020 | 392,100 | 23,678 | 6.0 |
Prior to the first year of the COVID-19 pandemic in 2020, there had been a significant upward trend in these indicators, as shown in figure 1. The percentage for all ages increased from 6.9% in 2015 to 8.2% in 2019. The percentage of people who had 3 or more emergency admissions in the last 3 months of life also increased significantly for those aged 75 years and over (5.7% to 7.0%) and those aged under 75 years (from 9.5% to 10.8%).
Due to the impact of the COVID-19 pandemic it is not possible to make clear comparisons between geographies in 2020.
Figure 1: The percentage of people with 3 or more emergency admissions in the last 3 months of life by age group: under 75 years and 75 years and over (England, 2015 to 2020)
Further details about the profile methodology are available within the definitions section of the online version of Palliative and End of Life Care Profiles.
Responsible statistician, product lead: Andy Pring, Julia Verne
For queries relating to this document, please contact: neolcin@dhsc.gov.uk