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Emergency admission Predictive RIsk Stratification Models: Assessment of Implementation Consequences (PRISMATIC 2): a

Mark Kingston¹, Helen Snooks², Alan Watkins²

¹Swansea University Medical School, Swansea University, Swansea, UK M.r.kingston@swansea.ac.uk.

|September 16, 2024

Summary

Emergency admission risk stratification (EARS) tools in primary care are increasingly used but their impact is unclear. This study assesses EARS effects, costs, and stakeholder views to inform policy and practice.

Area of Science:

Health Services Research
Primary Care Medicine
Health Policy Analysis

Background:

Emergency admissions are a significant cost and burden on healthcare systems.
Emergency Admission Risk Stratification (EARS) tools are implemented in primary care to predict and potentially reduce hospital admissions.
The real-world impact and unintended consequences of EARS tools remain poorly understood.

Purpose of the Study:

To evaluate the effects of EARS tool implementation in England.
To examine the mechanisms through which EARS tools influence healthcare utilization.
To understand the costs and perspectives of patients and healthcare professionals regarding EARS tools.

Main Methods:

A quasi-experimental mixed-methods design integrating routine anonymised data and qualitative research.
Interrupted time-series analysis of emergency admission trends at a regional level.
Qualitative interviews with GPs, healthcare staff, and patients to explore experiences and perceptions.

Main Results:

Analysis of routine data to assess changes in emergency admissions and healthcare use post-EARS implementation.
Investigation of GP decision-making and patient case-mix associated with emergency admissions before and after EARS.
Exploration of patient and healthcare professional views on EARS tool impact and communication.

Conclusions:

The study will provide crucial insights into the effectiveness and implications of EARS tools.
Findings will inform policymakers and healthcare providers on optimizing the use of risk stratification tools.
Understanding stakeholder perspectives is key to successful implementation and improved patient care.

Keywords:

clinical decision rules emergency medical services health services research primary health care

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