A DUNDEE University research team has developed a formula to predict emergency hospital admissions in people over 40, writes Marjory Inglis, health reporter.

They studied the medical records of more than 90,000 Tayside patients to arrive at the formula.

Peter Donnan, professor of epidemiology and biostatistics, led the team, whose work was published yesterday in Archives of Internal Medicine.

“The whole idea is perhaps we could intervene at an earlier stage with better case management to perhaps prevent the emergency admission,” said Professor Donnan.

The research was commissioned by NHS Tayside who, in common with health boards across the country, have seen a marked rise in emergency admissions.

“They want to stop people coming in unnecessarily,” said Prof Donnan. “It is well known emergency admissions are going up. They are on the rise everywhere, not just in Tayside.”

Several models have been developed previously to identify those at risk of emergency admission.

However, most have focused on those older than 65 or who have already had multiple emergency admissions.

They leave out people at high risk who are younger than 65, and those who have never had an emergency admission but are likely to in the future.

Professor Donnan said the formula was developed after studying anonymised medical records, looking at information from GP and hospital visits and from patients’ prescriptions.

He explained most GP practices now have electronic patient records and can “plug in” to the formula developed by his team and predict the risk for an individual patient.

Professor Donnan said it is similar to the way the risk of heart disease is identified in general practice using the Framingham Equation, which gives a score based on smoking, cholesterol, blood pressure and other indicators.

“Our formula is similar but based on previous history of hospital use and medication used asks what is the risk of emergency admission in the next year.

“If the risk is there then we can ask if there is something you could do to avoid that.”

The formula does not offer advice on how to intervene and Professor Donnan said there is a lot of debate around how clinical teams can do so appropriately, something heavily dependent on the diagnosis of illness or disease.

In the published study the researchers gave the example of a man aged 72, from a very deprived area, with eight previous admissions of 106 “bed days” in the previous three years.

He takes a range of drugs, including some for hypertension and heart failure drugs. His absolute risk of admission in the next year is 52.8%, the formula said.

A 50-year-old woman from an affluent area with no emergency admissions and one hospital admission with a one-day stay, who takes ulcer-healing drugs, diuretics and antibiotics would have a 2.4% risk of emergency admission in the next year.