Numbers and types of neurological emergencies in England and the influence of socioeconomic deprivation: a retrospective analysis of hospital episode statistics data

BMJ Open, 2022 · DOI: 10.1136/bmjopen-2022-061843 · Published: October 2, 2022

Simple Explanation

This study looked at hospital emergency admissions related to neurological conditions in England. It examined how many people were admitted for neurological emergencies, what conditions they had, and whether their socioeconomic status played a role. The researchers found that a significant number of emergency admissions involved neurological issues, with epilepsy being the most common. However, only a small percentage of these patients were seen by a neurologist or neurosurgeon. The study also revealed that people from more deprived areas were more likely to be admitted for certain neurological conditions, particularly epilepsy and functional neurological disorders (FNDs).

Study Duration

2019/2020 financial year

Participants

17 million in-year inpatient admissions in England including 6.5 million emergency admissions

Evidence Level

Not specified

Key Findings

1
Epilepsy was the most frequent neurological emergency, but only a small proportion of epilepsy admissions were managed by a neurologist.
2
A small percentage of emergency admissions with a neurological emergency code were under the care of a neurologist or neurosurgeon.
3
There is a significant association between socioeconomic deprivation and admissions for epilepsy and functional neurological disorders (FNDs).

Research Summary

This study analyzed neurological emergency admissions in England, identifying the number and types of admissions, specialist involvement, and the impact of socioeconomic deprivation. The findings revealed that epilepsy was the most common neurological emergency, but neurologist involvement was low. Socioeconomic deprivation was associated with increased admissions for epilepsy and FNDs. The study highlights the need for better understanding of neurological emergency admissions and improved clinical pathways, particularly for FND patients and those from deprived backgrounds.

Practical Implications

Workforce Planning

The findings underscore the need to address workforce capacity to support neurological emergency admissions, ensuring timely access to neurology specialists.

Service Delivery

Clinical pathway changes are needed to improve care for patients with neurological emergencies, particularly those with FND, to reduce avoidable admissions and improve care coordination across primary and secondary care.

Healthcare Equity

Addressing the relationship between socioeconomic deprivation and neurological emergency admissions requires targeted interventions to improve access to care and address social determinants of health.

Study Limitations

1
The inclusion of emergency admissions with mention of neurological conditions, rather than solely neurological emergencies per se, may affect the accuracy of the data.
2
Data were collected for healthcare delivery rather than research purposes.
3
The retrospective nature of the study limits interpretation of some findings.

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