AIMS
This project aims to understand how living with several long-term health conditions affects people admitted to hospital. Researchers will look at which conditions occur together, how they affect people’s health and recovery, and how people move through hospital services. The findings could help identify ways to improve care. The project is part of ADMISSION, a national research programme about people living with multiple long-term health conditions.
BACKGROUND
Many people admitted to hospital live with more than one long-term health condition. This is often referred to as multiple long-term conditions or multimorbidity. Examples might include someone living with diabetes, heart disease and kidney disease at the same time.
Healthcare services are often organised around treating one condition at a time, rather than all the health problems a person has. People living with several long-term conditions often stay in hospital longer, are more likely to return to hospital after leaving, and may have poorer health.
Diabetes, high blood pressure, heart disease and kidney disease often occur together. Researchers already know that some conditions commonly occur in the same person. Understanding why this happens and how it affects patients could help services organise care better. It could also help researchers develop treatments that address several conditions at the same time.
Very little research of this kind has focused specifically on people admitted to hospital. These patients often have more complex healthcare needs. Similar studies have looked at the wider population, rather than specifically at hospital patients.
RESEARCH
The study will use information recorded as part of the usual care of adults admitted to hospital. Researchers will study these existing hospital records.
Researchers will examine information relating to 60 different long-term health conditions and identify common patterns among patients. They will also look at:
- Length of hospital stay.
- Risk of readmission to hospital.
- Death rates following admission.
- Movement between wards and departments during a hospital stay.
- Where people go after leaving hospital and the steps in their care.
- How findings differ according to people’s age, sex, ethnicity, and social and financial circumstances, such as income and living conditions.
Researchers will compare findings across hospitals in Birmingham, Newcastle and London. This will help them understand whether similar patterns are found in different groups of patients and different hospital settings.
PATIENT AND PUBLIC INVOLVEMENT
People living with multiple long-term conditions helped decide which research questions the ADMISSION programme should focus on through a series of workshops. Patients have been involved from the beginning and continue to play an active role in the programme.
Patient representatives are named as co-applicants on the project application. A dedicated Patient Advisory Group gives ongoing advice on how the study is planned, what the findings mean and which research questions should be explored next. Patients have also helped develop the list of 60 conditions used throughout the study.
Their involvement helps ensure that the research focuses on issues that matter most to people living with multiple long-term conditions and their families.
APPROVAL
This project was supported unanimously by the PIONEER Data Trust Committee.
This work is led by Professor Miles Witham, Professor of Trials for Older People at Newcastle University, working in collaboration with researchers from Newcastle University, University Hospitals Birmingham and the University of Birmingham.
