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Short stay emergency admissions to a West Midlands NHS Trust : a longitudinal descriptive study, 2002–2005

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Sibly, E., Wiskin, C. M., Holder, Roger L. and Cooke, Matthew, MB ChB. (2007) Short stay emergency admissions to a West Midlands NHS Trust : a longitudinal descriptive study, 2002–2005. Emergency Medicine Journal, Vol.24 (No.8). pp. 553-557. ISSN 1472-0205

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Official URL: http://dx.doi.org/10.1136/emj.2006.043901

Abstract

Objectives: To describe changes and characteristics in emergency admissions to a West Midlands National Health Service Trust, 2002–2005, with a focus on short stay emergency admissions. Methods: A longitudinal descriptive study using retrospective analysis of routine admissions data. Admissions were categorised as short (0/1 day) or long (≥2 days) and examined separately using a General Linear Model. Factors favouring short stays as opposed to long stays were examined using multivariable logistic regression. Results: There were 151 478 emergency admissions to the Trust between 1 April 2002 and 31 December 2005, of which 2910 (1.92%) had no discharge date recorded. Adjusted means showed a 7.76% increase in emergency admissions in winter months (October–January) and a 14.50% increase across the study period. Increases were greater in short stay (34.03%) than long stay emergency admissions (8.38%). Odds of short stays in admitted patients increased by 25%. Higher odds of short stays were also associated with younger age, winter month and medical admitting specialty (p<0.001). Conclusions: Increases in emergency admissions were greater in short stay than long stay cases. Reasons for this may be both appropriate (increased use of clinical protocols and falling average length of stay) and detrimental (pressure to meet 4 h emergency department target, changing primary care provision). Further research is needed before generalising findings to other Trusts.

Item Type:	Journal Article
Subjects:	R Medicine > R Medicine (General)
Divisions:	Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Hospitals -- Admission and discharge -- Statistics -- England -- West Midlands, Emergency medicine -- Statistics -- England -- West Midlands, Hospital utilization -- Length of stay -- England -- West Midlands
Journal or Publication Title:	Emergency Medicine Journal
Publisher:	BMJ Group
ISSN:	1472-0205
Date:	2007
Volume:	Vol.24
Number:	No.8
Page Range:	pp. 553-557
Identification Number:	10.1136/emj.2006.043901
Status:	Peer Reviewed
Access rights to Published version:	Open Access
References:	1 Department of Health. Hospital activity statistics, www.performance.doh.gov.uk/ hospitalactivity/data_requests/index.htm(accessed 12 April 2006).. 2 Munro J, Mason S, Nicholl J. Effectiveness of measures to reduce emergency department waiting times: a natural experiment. Emerg Med J 2006;23:35–9. 3 NHS Health and Social Care Information Centre. Hospital episode statistics, www.hesonline.nhs.uk/Ease/servlet/DynamicPageBuild; jsessionid = xxqw03xwb1siteID = 1802&categoryID = 62.(accessed 12 May 2006).. 4 Capewell S. The continuing rise in emergency admissions. BMJ 1996;312:991–2. 5 Cooke MW, Wilson S, Halsall J, et al. Total time in English accident and emergency department is related to bed occupancy. Emerg Med J 2004;21:575–6. 6 Kendrick S. The pattern of increase in emergency hospital admissions in Scotland. Health Bulletin 1996;54:101–9. 7 Hardy C, Whitwell D, Sarsfield B, et al. Admission avoidance and early discharge of acute hospital admissions: an accident and emergency based scheme. Emerg Med J 2001;18:435–40. 8 Morgan K, Prothero D, Frankel S. The rise in emergency admissions-crisis or artefact? Temporal analysis of health services data. BMJ 1999;319:158–9. 9 Blatchford O, Capewell S. Emergency medical admissions: taking stock and planning for winter. BMJ 1997;315:1322–3. 10 NHS Institute for Innovation and Improvement. Delivering quality and value focus document, www.institute.nhs.uk/NHSInstitute/Products/ DeliveringQualityandValueFocusDocument.htm(accessed 11 May 2006). 11 Neighbourhood Statistics 2004. www.neighbourhood.statistics.gov.uk/ dissemination/NeighbourhoodProfileSearch(accessed 9 May 2006). 12 Altman D. Practical statistics for medical research. London: Chapman and Hall, 1991. 13 Powell AE, Davies HO, Thomson RG. Using routine comparative data to assess the quality of health care: understanding and avoiding common pitfalls. Qual Saf Health Care 2003;12:122–8. 14 McMullan R, Silke B, Bennett K, Callachand S. Resource utilisation, length of hospital stay, and pattern of investigation during acute medical hospital admission. Postgrad Med J 2004;80:23–6. 15 Moloney ED, Bennett K, Silke B. Length of hospital stay, diagnoses and pattern of investigation following emergency admission to an Irish teaching hospital. Ir Med J 2004;97:170–2. 16 Downing A, Wilson R. Temporal and demographic variations in attendance at accident and emergency departments. Emerg Med J 2002;19:531–5. 17 Goodacre S, Cross E, Arnold J, et al. The burden of acute chest pain. Heart 2005;91:229–30. 18 Black P, Pearson M. Average length of stay, delayed discharge, and hospital congestion. BMJ 2002;325:610. 19 Department of Health. The NHS Plan. A plan for investment, a plan for reform, Cm 4818-I. Norwich: The Stationary Office, 2000. 20 Charlton R. Implications of the new GP contact. Clin Med 2005;5:50–4.
URI:	http://wrap.warwick.ac.uk/id/eprint/3344