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dc.contributor.authorMorciano, Marcello; orcid: 0000-0002-0009-5201; email: marcello.morciano@manchester.ac.uk
dc.contributor.authorCheckland, Katherine; orcid: 0000-0002-9961-5317
dc.contributor.authorDurand, Mary Alison; orcid: 0000-0003-2205-4002
dc.contributor.authorSutton, Matt; orcid: 0000-0002-6635-2127
dc.contributor.authorMays, Nicholas; orcid: 0000-0001-9808-8466
dc.date.accessioned2021-07-12T15:12:22Z
dc.date.available2021-07-12T15:12:22Z
dc.date.issued2021-07-12
dc.date.submitted2020-10-28
dc.identifierhttps://chesterrep.openrepository.com/bitstream/handle/10034/625229/additional-files.zip?sequence=2
dc.identifierhttps://chesterrep.openrepository.com/bitstream/handle/10034/625229/12913_2021_Article_6692_nlm.xml?sequence=3
dc.identifierhttps://chesterrep.openrepository.com/bitstream/handle/10034/625229/12913_2021_Article_6692.pdf?sequence=4
dc.identifier.citationBMC Health Services Research, volume 21, issue 1, page 687
dc.identifier.urihttp://hdl.handle.net/10034/625229
dc.descriptionFrom Springer Nature via Jisc Publications Router
dc.descriptionHistory: received 2020-10-28, accepted 2021-06-23, registration 2021-06-26, pub-electronic 2021-07-12, online 2021-07-12, collection 2021-12
dc.descriptionPublication status: Published
dc.descriptionFunder: Research for Social Care within Research for Patient Benefit (RfPB) Programme; Grant(s): NIHR201872
dc.descriptionFunder: National Institute for Health Research; doi: http://dx.doi.org/10.13039/501100000272; Grant(s): PR-R10-0514-25001, PR-R16-0516-22001
dc.description.abstractAbstract: Background: Policy-makers expect that integration of health and social care will improve user and carer experience and reduce avoidable hospital use. [We] evaluate the impact on emergency hospital admissions of two large nationally-initiated service integration programmes in England: the Pioneer (November 2013 to March 2018) and Vanguard (January 2015 to March 2018) programmes. The latter had far greater financial and expert support from central agencies. Methods: Of the 206 Clinical Commissioning Groups (CCGs) in England, 51(25%) were involved in the Pioneer programme only, 22(11%) were involved in the Vanguard programme only and 13(6%) were involved in both programmes. We used quasi-experimental methods to compare monthly counts of emergency admissions between four groups of CCGs, before and after the introduction of the two programmes. Results: CCGs involved in the programmes had higher monthly hospital emergency admission rates than non-participants prior to their introduction [7.9 (95% CI:7.8–8.1) versus 7.5 (CI: 7.4–7.6) per 1000 population]. From 2013 to 2018, there was a 12% (95% CI:9.5–13.6%) increase in emergency admissions in CCGs not involved in either programme while emergency admissions in CCGs in the Pioneer and Vanguard programmes increased by 6.4% (95% CI: 3.8–9.0%) and 8.8% (95% CI:4.5–13.1%), respectively. CCGs involved in both initiatives experienced a smaller increase of 3.5% (95% CI:-0.3–7.2%). The slowdown largely occurred in the final year of both programmes. Conclusions: Health and social care integration programmes can mitigate but not prevent rises in emergency admissions over the longer-term. Greater financial and expert support from national agencies and involvement in multiple integration initiatives can have cumulative effects.
dc.languageen
dc.publisherBioMed Central
dc.rightsLicence for this article: http://creativecommons.org/licenses/by/4.0/
dc.sourceeissn: 1472-6963
dc.subjectResearch Article
dc.subjectHealth policy, reform, governance and law
dc.subjectHealth policy
dc.subjectSocial care policy
dc.subjectIntegrated care
dc.subjectVanguard
dc.subjectPioneers
dc.subjectEngland
dc.titleComparison of the impact of two national health and social care integration programmes on emergency hospital admissions
dc.typearticle
dc.date.updated2021-07-12T15:12:22Z
dc.date.accepted2021-06-23


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