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Acute medical admissions

In an acute medical admission, a person is admitted to a hospital because they require urgent specialist attention, for any of a wide range of medical or frailty-related conditions.

An increase in acute medical admission rates may reflect improved access to health care but is more likely to represent a deterioration in the health status of the population and/or lost or underexplored opportunities to both protect against risk factors for developing long-term conditions and support people to manage those conditions by providing good care in the community (mainly through organised general practice) [8].

The most likely drivers of change in acute medical admission rates include: changes to provision of primary and community health care services [41]; demographic changes (for example an ageing population or changes in the proportions in different ethnic groups); shifts in the socioeconomic status of the population; changes in the prevalence of disease [42], including due to changes in risk factors such as smoking and alcohol consumption [43]; changes in the social context, such as increased expectations from patients; and other unknown factors [8].

Canterbury has had a long-standing primary care-led acute demand programme (Acute Demand Management Services, ADMS) that has focused on hospital admission avoidance, and 34,000 people were managed in the community in 2018/19 via the ADMS. The impact of this programme has been to enable a lower level of hospital admissions in Canterbury.

This indicator presents the age-standardised rate of acute medical admissions per 100,000 population, for all ages, in the Canterbury DHB region and New Zealand, 2008–2019.

The figure shows that the age-standardised rate of acute medical admissions has been steadily increasing over time in Canterbury DHB, and in New Zealand overall (Canterbury DHB, 4,743/100,000 and New Zealand, 6,809/100,000 in 2008/09 compared with Canterbury DHB, 5,772/100,000 and New Zealand, 7,945/100,000 in 2018/19). During the period 2008/09 to 2018/19, Canterbury DHB has maintained a lower age-standardised acute medical admission rate than New Zealand overall (≈30% difference).