Focusing on patients with at least two emergency admissions in the previous year, compared with patients at control practices, those from the Evercare scheme were 2.5 per cent more likely to have emergency admissions, and had a 5.5 per cent increased risk of mortality.
However, they spent less time in hospital, with a 4.9 per cent reduction in emergency bed days.
Hospital episode statistics for 62 practices in England using Evercare between June 2003 and March 2005 were compared with those for around 7,000 control practices. The pilots pre-empt the introduction of nurse-led case management in England, with 3,000 community matrons due to be in place by 2007.
Case management was popular among patients, but experts said the cost of community matrons cannot be justified if there was no improvement to health.
The findings could undermine some practice-based commissioning schemes which intended to save money by cutting hospital admissions using community matrons (GP, 17 February).
Lead researcher Professor Martin Roland, director of the National Primary Care Research and Development Centre at Manchester, said: ‘It was never likely that this would make an impact on admissions, and it’s not going to save money.’
Dr Andrew Dearden, chairman of the GPC community care committee, said: ‘What this seems to show is that patients like it because there’s someone there to talk to, which is a benefit for patients, but it doesn’t benefit patient health.
‘Does the DoH want to improve people’s health or do they want people to feel emo-tionally better?’
Emergency bed days