The Percentage of Deaths With 3 or More Emergency Admissions in the Last 3 Months of Life
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
Defining Attributes
Definition
Intended as a measure of end of life care services, this is not a direct measure of the quality of care at the individual level. It is actively monitored by Sustainable Transformation Partnerships and Clinical Commissioning Groups that are encouraged to investigate when this measure is high, which could indicate: poor identification of people at risk of death, poor planning and availability of services, poor communication, co-ordination and information sharing.
Numerator
The number of people with three or more emergency admissions in the last three months or year of life, taken from Hospital Episode Statistics (HES) with linked Office for National Statistics (ONS) mortality data.
Denominator
The total number of deaths, excluding neonatal deaths. Figures are for deaths of people resident in England and are based on deaths registered rather than deaths occurring each year.
Exclusions
Denominator total numbers of deaths exclude those of neonates (28 days or younger). Excludes any deaths for which the linked mortality data quality marker suggesting the matched Hospital Episode Statistics data includes activity after the date of death.
Use of Risk Adjustment
Risk Adjustments
Stratifications
Sex, age at death (by all ages, under 75 years, 75 years and older), cause of death and where they live (region, social deprivation and rurality). International Classification of Diseases (ICD) categories ARE used to classify the following cause of death: cancer: C00-C97 (excluding C44); dementia: F00-F04, G30-G31; acute heart disease (AHD): I20-I25, I39, I40-I41, I46-I49, I51; chronic obstructive pulmonary disease (COPD): J40-J44; pneumonia: J12-J18; stroke: I60-I69; chronic heart disease (CHD): I05-I11, I13, I31, I34-I36, I38, I42, I50, I70, I95; liver disease: B15-19, K70-77; falls: W00-19.
Data Attributes
Type of Data Collection
Data Collection Methods
Produced by Public Health England and based on the following data sources: Hospital Episode Statistics (HES); Linked Hospital Episode Statistics-Office for National Statistics (HES-ONS) mortality extract; Office for National Statistics: Public Health England Annual Births and Mortality Extracts.
Frequency of Data Collection
Frequency of Data Collection in Days
Reporting Methods
Public reporting.
Reporting Frequency
Reporting Frequency in Days
Indicator Has Recommended Targets
Source and Reference Attributes
Evidence Source
www.gov.uk/government/statistics/palliative-and-end-of-life-care-profiles-december-2023-data-update/palliative-and-end-of-life-care-profile-december-2023-update-statistical-commentary www.gov.uk/government/publications/emergency-admissions-in-the-3-months-before-death/emergency-admissions-in-the-3-months-before-death#methods www.nuffieldtrust.org.uk/resource/end-of-life-care
Technical Specifications
Unable to locate full specifications. Some details available here: www.gov.uk/government/publications/emergency-admissions-in-the-3-months-before-death/emergency-admissions-in-the-3-months-before-death