1089 
An advanced tool that enables primary care trusts to identify patients most at risk of emergency re-admission to hospital has been offered to the NHS.
Freely-available to the health service, the computer programme is designed to help PCTs predict patients most at risk of needing hospital treatment in the next year.
PCTs can then better target care for these patients, reducing ill health so that expensive hospital care is needed less.
The tool is a new version of a free computer programme, called Patients at Risk of Re-hospitalisation (PARR), originally developed for the Department of Health in 2006 through a partnership between the King’s Fund, Health Dialog UK – a subsidiary of Health Dialog Services Corporation – and New York University.
More than two thirds of PCTs are believed to be using the original tool, which is considered an important method for identifying patients most at risk of hospital admission.
Some 5% of patients currently account for 49% of NHS acute bed days. Patients with long-term conditions such as congestive heart disease, diabetes and chronic obstructive pulmonary disease are frequently and sometimes unnecessarily admitted to hospital.
The new tool, known as PARR++, uses routine inpatient data to predict which patients are at risk of re-admission to hospital in the next 12 months, allowing doctors, nurses and other staff to work with the patient to design better care to reduce the risk of admission in future.
“Tools such as PARR++ will play an important part in supporting commissioners to achieve World Class Commissioning,” said Mark Britnell, Director General of Commissioning and System Management at the Department of Health.
“Its ability to proactively identify people at risk who can be offered more timely and appropriate interventions is a fundamental element of an improved commissioning function. Most importantly, it will be patients who will benefit from receiving the most appropriate care in the most appropriate setting.”
The PARR++ software takes into account a range of factors such as frequency of admission, diagnoses, speciality of consultant seen and socio-demographic characteristics to give each individual a score out of 100 that reflects their future risk of re-admission.
This allows a PCT to target appropriate case management or other interventions at those individuals most at risk of emergency re-admission to hospital. This will help reduce the risk of emergency admission in future and enable a better quality of life for patients who are prevented from entering into revolving door emergency admissions.
