An evaluation of the impact of community-based interventions on hospital useAuthors: Adam Steventon, Martin Bardsley, John Billings, Theo Georghiou and Geraint Lewis

March 2011 © Nuffield Trust

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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

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We linked participants to hospital data at the person level

© Nuffield TrustSource: Department of Health analysis of Hospital Episode Statistics for England

The importance of a control group: regression to the mean in the absence of a specific intervention

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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

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Prevalence of health diagnosis categories in intervention and control groups (intervention D)

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Intermediate care service (intervention B)

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Intermediate care service (intervention B)

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None of the interventions were associated with overall reductions in hospital admissions

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