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Research project: The relationship between physiological impairment, chronic disease and function disability in older people admitted to hospital with ill-defined conditions - Dormant - Dormant

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Hospital admission rates are rising more rapidly for those over 65 than for other age groups and older people now occupy over two thirds of general and acute hospital beds. In addition to the costs to the NHS, this trend is undesirable for patients; older people face considerable risks from hospital admission, including dependency, disorientation, hospital-acquired infection, loss of social networks and premature admission to residential care. There is therefore an urgent need to identify conditions which might contribute to avoidable admissions in order to reduce the incidence of such admissions for older people.


Many emergency admissions are known to be for alleviation of signs, symptoms and functional disorders (known as ill-defined conditions) rather than a definitive medical problem, and may therefore be avoidable.

 Admissions for ill-defined conditions are rising in incidence amongst older people, from 350,000 hospital inpatient episodes in 1999 to 432,702 inpatient episodes in 2002. The average length of stay for these admissions is eight days, and readmission rates are high amongst this patient group. However, interventions to reduce admissions or improve management for this patient group require knowledge of the nature of their underlying health problems, which are not currently understood. Elucidation of these underlying health problems is essential to identifying potential nursing interventions to reduce avoidable admission for these patients.

It has previously been assumed that these patients' needs are psychological or social rather than physical, even though it has been observed that these patients experience high rates of chronic illnesses. Chronic diseases can result in sub-clinical inflammatory processes with consequent decline in physical, psychological and social function which may be sufficiently severe to require hospitalisation. It is hypothesised that the functional problems reported by this patient group will be associated with physiological features related to chronic disease in older people, for example, sub-clinical levels of inflammation, anaemia, weight loss and weakness.

Main question(s)

Are functional disability and patient-reported problems associated with physiological changes resulting from chronic disease and ageing?


Retrospective, single group, correlational study of key physiological and functional parameters in older people admitted to hospital with ill-defined conditions combined with semi-structured qualitative interviews to explore social support.

Project team

Bronagh Walsh, David Voegeli 

Project funder

Faculty of Medicine Health and Biological Sciences, University of Southampton

Related research groups

Health Work and Systems
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