EDITORIALS

Acute hospital care for frail older people Community-based alternatives can provide safe and effect-ive ways of managing the demand for inpatient hospital care for older people [1–3]. Patients and carers prefer home treatment where possible. However, the diversion of less severe or less complex acute care into the community can only increase the average levels of illness severity and com-plexity among those admitted to hospital. Therefore, as the population demography and community-based acute care processes change and develop, the provision of effective inpatient care for frail older people is becoming a key issue. In NHS hospitals in England in 2004–05, of 2.5 million epi-sodes of care in which the main specialty was General Med-icine, 77 % were emergency admissions, and 63 % of admitted patients were>60 years [4]. Among this majorit