1. An evaluation of the impact of
community-based interventions
on hospital use
Authors: Adam Steventon, Martin Bardsley,
John Billings, Theo Georghiou and Geraint Lewis
March 2011 © Nuffield Trust

2. From the 146 interventions offered under POPP, we
selected eight for an in-depth study of hospital use
• Support workers for community matrons
• Intermediate care service with generic workers
• Integrated health and social care teams
• Out-of-hours and daytime response service
• Four different short-term assessment and signposting
services
© Nuffield Trust

3. We linked participants to hospital data at the person level
© Nuffield Trust

4. The importance of a control group: regression to the mean
in the absence of a specific intervention
Source: Department of Health analysis of Hospital Episode Statistics for England © Nuffield Trust

5. We selected controls retrospectively from other
areas of England
• In the absence of a randomised controlled trial, we compared
participants to matched controls
• We ensured that controls were similar to participants in terms of:
• age
• sex
• area deprivation
• recorded health diagnoses
• prior hospital use
• predicted risk score
• There may still be differences that we cannot observe
© Nuffield Trust

6. Prevalence of health diagnosis categories in
intervention and control groups (intervention D)
© Nuffield Trust

7. Intermediate care service (intervention B)
© Nuffield Trust

8. Intermediate care service (intervention B)
© Nuffield Trust

9. None of the interventions were associated with overall
reductions in hospital admissions
*denotes statistically significant at the 5% level. © Nuffield Trust

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© Nuffield Trust