New ELSA analysis links social care needs to emergency hospital admissions
- 1 day ago
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Older people with social care needs are significantly more likely to be admitted to hospital as emergencies and to experience repeat admissions, according to new analysis using linked ELSA and NHS data
The study draws on five waves of ELSA data collected between 2012 and 2023, covering 4,808 participants aged 65 and over. It compares people with no care needs to those with mobility or self-care difficulties whose needs were mostly met, those whose needs were mostly unmet, and those with difficulties limited to everyday independent tasks.
Clear differences were observed between these groups. Older people with mobility or self-care difficulties were more likely to be admitted to hospital as an emergency than those with no such difficulties. This was true whether they were receiving help or not. After taking account of age, long-term conditions, deprivation, living arrangements and lifestyle factors, people whose mobility or self-care needs were mostly met had just over twice the odds of an emergency admission compared with those with no needs. Those with unmet needs also had raised odds, though to a lesser extent.
This pattern should not be interpreted as care increasing the risk of hospital admission. Rather, it reflects the greater vulnerability of people who have substantial mobility or self-care difficulties. The group receiving help tended to have more severe needs and a higher burden of long-term health conditions. Even after adjusting for these factors, they remained at particularly high risk of emergency admission.
The study also shows that unmet need remains common. Among participants aged 65 and over between 2012 and 2023, 31% had unmet mobility or self-care needs, compared with 8% whose needs were mostly met. People with any type of care need also experienced a higher number of admissions on average than those without needs.
Qualitative interviews with older participants provide insight into how these patterns play out in practice. Several described delays in accessing support and confusion about entitlements. In some cases, formal care was introduced only after a hospital stay, suggesting that support often follows a crisis rather than preventing one. Falls, chest infections and flare-ups of chronic conditions were frequently cited as reasons for admission, many of which may be avoidable with earlier intervention and stronger community support.
By combining long-running survey data with linked NHS records and in-depth interviews, the research provides new evidence on the relationship between functional difficulties, social care support and emergency hospital use in later life. The findings contribute to ongoing policy discussions about adult social care reform and pressures on the NHS.
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