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Expanding emergency department capacity: a multisite study.
- Source :
- Australian Health Review; 2014, Vol. 38 Issue 3, p278-287, 10p, 5 Charts
- Publication Year :
- 2014
-
Abstract
- Objectives. The aims of the present study were to identify predictors of admission and describe outcomes for patients who arrived via ambulance to three Australian public emergency departments (EDs), before and after the opening of 41 additional ED beds within the area. Methods. The present study was a retrospective comparative cohort study using deterministically linked health data collected between 3 September 2006 and 2 September 2008. Data included ambulance offload delay, time to see doctor, ED length of stay (LOS), admission requirement, access block, hospital LOS and in-hospital mortality. Logistic regression analysis was undertaken to identify predictors of hospital admission. Results. Almost one-third of all 286 037 ED presentations were via ambulance (n = 79 196) and 40.3% required admission. After increasing emergency capacity, the only outcome measure to improve was in-hospital mortality. Ambulance offload delay, time to see doctor, ED LOS, admission requirement, access block and hospital LOS did not improve. Strong predictors of admission before and after increased capacity included age >65 years, Australian Triage Scale (ATS) Category 1-3, diagnoses of circulatory or respiratory conditions and ED LOS >4 h. With additional capacity, the odds ratios for these predictors increased for age >65 years and ED LOS >4 h, and decreased for ATS category and ED diagnoses. Conclusions. Expanding ED capacity from 81 to 122 beds within a health service area impacted favourably on mortality outcomes, but not on time-related service outcomes such as ambulance offload time, time to see doctor and ED LOS. To improve all service outcomes, when altering (increasing or decreasing) ED bed numbers, the whole healthcare system needs to be considered. [ABSTRACT FROM AUTHOR]
- Subjects :
- HOSPITAL emergency services
EVALUATION of medical care
AGE distribution
CHI-squared test
COMPARATIVE studies
CONFIDENCE intervals
EMERGENCY medical services
HOSPITAL utilization
LENGTH of stay in hospitals
HOSPITALS
HOSPITAL admission & discharge
HOSPITAL information systems
INFORMATION storage & retrieval systems
MEDICAL databases
LONGITUDINAL method
MEDICAL cooperation
DEATH rate
HEALTH outcome assessment
PATIENTS
RESEARCH
RESEARCH funding
STATISTICS
U-statistics
LOGISTIC regression analysis
RETROSPECTIVE studies
DATA analysis software
DESCRIPTIVE statistics
INFERENTIAL statistics
TREATMENT delay (Medicine)
ODDS ratio
Subjects
Details
- Language :
- English
- ISSN :
- 01565788
- Volume :
- 38
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- Australian Health Review
- Publication Type :
- Academic Journal
- Accession number :
- 96384758
- Full Text :
- https://doi.org/10.1071/AH13085