PP62 Predictors of Conveyance to Hospital by Ambulance Services of Care Home Patients

Background Residents of care homes may be affected by medical emergencies, resulting in ambulance attendance and conveyance to hospital which add extra pressure and costs on an already strained emergency and healthcare system. The aim of this study was to determine the factors predicting conveyance to hospital of care home residents by ambulance services. Methods We used a cross-sectional study design analysing routine data from electronic clinical records from East Midlands Ambulance Service NHS Trust (EMAS) from 2018 to 2021. A multivariable multinominal regression model was used to identify the main predictors of conveyance to hospital or referral to community services. Results The data included 170,612 attendances to care homes representing 7.5% of the total number of EMAS attendances between 2018-2021. The main predictors of conveyance to hospital were being male (Relative Risk Ratio [RRR] 1.07, 95% Confidence Interval [CI] 1.03-1.10, p<0.001), aged 70-79 years (RRR 1.09, 95%CI 1.03-1.17, p<0.001) or 80-89 years (RRR 1.10, 95%CI 1.03-1.17, p<0.001), situated in an area of higher deprivation (RRR 1.06, 95%CI 1.03-1.09, p<0.001), or having dispatch categories which included cardiovascular (RRR 11.29, 95%CI 10.43-12.22, p<0,001), trauma including falls (RRR 9.50, 95%CI 8.97-10.05, p<0,001) or neurological (RRR 9.06, 95%CI 8.42-9.75, p<0,001) conditions. Calls made by health care professionals (HCPs) (RRR 15.37, 95%CI 13.41-17.62, p<0,001) or where patients had a higher National Early Warning Score (NEWS2) (RRR 1.23, 95%CI 1.22-1.24, p<0,001) resulted in significantly increased conveyance. Conclusion A series of factors significantly predict conveyance to hospital by ambulance of home care residents. These include HCP referral or NEWS2 confirming that the severity of clinical condition of the patient was associated with significantly increased conveyance. Future interventions to prevent or address certain conditions such as falls or provide enhanced care in care homes may prevent some emergencies or reduce the risk of conveyance to hospital.