18/120 Identification of older patients likely to require enhanced care on discharge from hospital


The aim of the HTA Programme is to ensure that high quality research information on the effectiveness, costs and broader impact of health technology is produced in the most efficient way for those who use, manage, provide care in or develop policy for the NHS. Topics for research are identified and prioritised to meet the needs of the NHS. Health technology assessment forms a substantial portfolio of work within the National Institute for Health Research and each year about fifty new studies are commissioned to help answer questions of direct importance to the NHS. The studies include both primary research and evidence synthesis.

Research Question:

Can a prediction tool be developed to identify frail older inpatients at high risk of discharge to residential or nursing care, or with a need for intensive support at home?

1. Technology: A prediction tool, utilising routinely collected and dynamic data from hospital electronic patient record systems, e.g. Epic or similar systems, to identify older patients likely to be discharged to residential or nursing care or, having a need for intensive support at home.

2. Patient group: Older people admitted to hospital (≥65 years of age, or justified by applicant).

3. Setting: Hospital inpatients.

4. Study design: Applications should describe the development and validation of a tool, or propose the adaptation of an existing tool. The tool may incorporate data from other assessment scales, e.g. severity of illness scoring systems, comprehensive geriatric assessments, etc. Qualitative research is also required to understand the context and how such a tool might be used in care.

5. Important outcomes: Predictive accuracy for risk of discharge to residential/nursing care, or need for intensive support; sensitivity to changes in functional ability and to likely place of discharge, 30 day readmission rates; time to discharge readiness. Other outputs: A validated prediction tool with the capability to be adapted to run on different platforms; findings of the qualitative research.

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