Start and end dates

June 2015 to May 2017

Project summary


What drives variation between hospitals? Heart failure and chronic lung disease (COPD) are common, serious conditions. Each affects around one million people in the UK, who often have other medical problems as well. Studies have shown that there are important variations across the country in how well patients do during and following admission to hospital for these conditions, but we still have a limited understanding of why this is. We aim to improve on this by bringing together a range of databases and surveys in England. Information on community services will be collected by survey with support from two national associations: the National Audit of Cardiac Rehabilitation and the British Thoracic Society.

The project builds on our previous NIHR-funded work on predicting risk of readmission and other patient outcomes using hospital administrative data. The team has expertise in statistics, medicine, epidemiology and health services research using large databases, and also includes two patient representatives to advise on the project’s scope and reporting our findings.


  • To describe and explain variations in rates of emergency readmission and mortality in patients with HF COPD
  • To survey the numbers, types and activities of community services across England for these conditions
  • To explore what A&E attendance data can add to our understanding of readmission rates


Bottle A, Goudie R, Bell D, Aylin P, Cowie MR. Use of hospital services by age and comorbidity after an index heart failure admission in England: an observational study. BMJ Open 2016; 6:e010669. BMJOpen

HSRUK oral presentation 2016