D J Pereira Gray

Emergency hospital admissions for the elderly: insights from the Devon Predictive Model

BACKGROUND In the UK, people aged 85 and over are the fastest growing population group and are predicted to double in number by 2030. Emergency hospital admissions are also rising. METHODS All emergency admissions for the registered population in Devon to all English hospitals were analysed by age, and admission rates per thousand registered were calculated. The Devon Predictive Model (DPM) was built, using local data, to predict emergency admissions in the following 12 months. This model was compared with the Combined Predictive Model over five risk categories. RESULTS The registered Devon population on 31 March 2011 was 761 652 with 65 892 emergency admissions in 2010/2011. The DPM had 89 variables including several local factors which strengthened the model. Three of the four most powerful predictors were age 85-89, 90-94 and 95 and over. The positive predictive value for the DPM was better than the CPMs in all five risk categories. Half (49.6%) of all emergency admissions were from those aged 65 or over. Admissions rose progressively and significantly in each successive elderly age band. At age 85 and over there were 420 emergency admissions per thousand registered. CONCLUSIONS Age, especially 85 and over, has been undervalued as a risk factor for emergency hospital admissions.

Teenagers' Use of Emergency Contraception in a General Practice

British teenagers who become pregnant commonly express ignorance about emergency contraception. A case-note survey was conducted in a general practice serving about 14 200 people in a Devon market town. Of the 373 registered girls aged 15–19 years, 59 (16%) had consulted for emergency contraception, 19 of them more than once. The oral method (Yuzpe regimen) was prescribed eighty times and 2 girls became pregnant. 4 of the 59 girls who used emergency contraception had subsequent unwanted pregnancies. A consultation for emergency contraception presents an opportunity to discuss more reliable and acceptable methods of contraception.

The cost of diagnosing Type 2 diabetes mellitus by clinical opportunistic screening in general practice

Diabet. Med. 29, 863–868 (2012)

The diagnosis of diabetes

© 2007 The Authors. Journal compilation