Patient Perspectives on the Acceptability of Emergency Admission Risk Prediction: A Focus Group Study

Background: Emergency admission risk stratification (EARS) tools predict admission risk for a general practice patient population.Policy has encouraged targeting higher risk patients with proactive care approaches, in partnership with patients.Previously published stakeholder views on the acceptability and use of EARS tools have been limited to professionals.Objective: Our objective was to explore the views of patients on acceptability, benefits, challenges and risks of communicating emergency admission risk scores to patients. Design, setting and participants:We undertook an in-person focus group with a geographically diverse group of patient and public members in Wales, UK.Participants brought experience of multiple health providers.All had chronic conditions and/or recent experience of emergency admission to hospital.We coded and thematically analyzed the transcript.Results: Participants supported the use of EARS where it was underpinned by communication of risk scores and direct involvement of patients.Participants expressed a desire to receive their own risk scores.They felt EARS use was well suited to holistic approaches to care, and as a stimulus to self-management.They recognized capacity and cost challenges related to general practitioner use but saw potential for other primary and community staff to be involved.The security and integrity of EARS data was deemed important. Conclusions:This study provides a rare insight from a stakeholder group that has largely been excluded from debates around EARS use.These findings identify issues that are deserving of further exploration to improve our understanding of the potential role and effectiveness of EARS and other risk approaches in healthcare. Patient or public contribution:This study was conceived following discussion with public contributors to a trial of emergency admission risk stratification (PRISMATIC) [1], and a subsequent informal workshop with eight members of a patient, carer and public member group aligned to research around chronic conditions management in Wales, UK [2].This preliminary work emphasized the importance of patient involvement in debates around EARS and contributed to the study reported here and to the information sheet and topic guide.JD, a public contributor, was a co-applicant on PRISMATIC, took part in a preliminary workshop, and is a co-author of this paper.