Overlap of hospital use and social care in older people in England

Objectives: To link pseudonymous health and social care use data in order to determine what proportion of older people access hospital and social care services. Methods: Retrospective analysis of linked, pseudonymous, routine service use data of people aged 75 and over (n = 133,055) drawn from the operational systems of four primary care trusts and their corresponding local authorities in England. Results: Fourteen percent of older people received local authority-funded social care in one year, 59% accessed NHS hospital care and 10% accessed both types of service. Most people using social care also used a hospital service (71%). This was a higher proportion than for people who did not use social care services (57%, P < 0.001). However, the use of hospitals varied by type of social care such that the residents of care homes had fewer admissions to hospital, fewer Accident and Emergency attendances and fewer outpatient visits than people receiving high intensity home care. Conclusions: Using routine data from large populations, we have demonstrated interactions in the use of hospital care and social care for older people. Residents of care homes tend to use hospitals less frequently than people receiving home care. More detailed work is required to explain this phenomenon.