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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Impact of opening a new emergency department on healthcare service and patient outcomes: Analyses based on linking ambulance, emergency and hospital databases
Internal Medicine Journal, Volume 43, No. 12, Year 2013
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Description
Background:: Emergency department (ED) crowding caused by access block is an increasing public health issue and has been associated with impaired healthcare delivery, negative patient outcomes and increased staff workload. Aim: To investigate the impact of opening a new ED on patient and healthcare service outcomes. Methods: A 24-month time series analysis was employed using deterministically linked data from the ambulance service and three ED and hospital admission databases in Queensland, Australia. Results: Total volume of ED presentations increased 18%, while local population growth increased by 3%. Healthcare service and patient outcomes at the two pre-existing hospitals did not improve. These outcomes included ambulance offload time: (Hospital A PRE: 10min, POST: 10min, P < 0.001; Hospital B PRE: 10min, POST: 15min, P < 0.001); ED length of stay: (Hospital A PRE: 242min, POST: 246min, P < 0.001; Hospital B PRE: 182min, POST: 210min, P < 0.001); and access block: (Hospital A PRE: 41%, POST: 46%, P < 0.001; Hospital B PRE: 23%, POST: 40%, P < 0.001). Time series modelling indicated that the effect was worst at the hospital furthest away from the new ED. Conclusions: An additional ED within the region saw an increase in the total volume of presentations at a rate far greater than local population growth, suggesting it either provided an unmet need or a shifting of activity from one sector to another. Future studies should examine patient decision making regarding reasons for presenting to a new or pre-existing ED. There is an inherent need to take a 'whole of health service area' approach to solve crowding issues. © 2013 Royal Australasian College of Physicians.
Authors & Co-Authors
Crilly, Julia L.
Australia, Southport
Gold Coast Health
Australia, Southport
Menzies Health Institute Queensland
Australia, Brisbane
State Wide Emergency Department Network
O'Dwyer, John A.
Australia, Southport
Gold Coast Health
Australia, Southport
Menzies Health Institute Queensland
Australia, Canberra
Commonwealth Scientific and Industrial Research Organisation
Australia, Brisbane
Queensland Emergency Medicine Research Foundation
Lind, James F.
Australia, Southport
Gold Coast Health
Australia, Brisbane
State Wide Emergency Department Network
Tippett, Vivienne C.
Australia, Brisbane
Queensland University of Technology
Thalib, Lukman
Australia, Southport
Menzies Health Institute Queensland
Kuwait, Kuwait City
Kuwait University
O'Dwyer, Marilla A.
Australia, Canberra
Commonwealth Scientific and Industrial Research Organisation
Keijzers, Gerben B.J.M.
Australia, Southport
Gold Coast Health
Australia, Southport
Menzies Health Institute Queensland
Australia, Brisbane
State Wide Emergency Department Network
Australia, Gold Coast
Bond University
Wallis, Marianne Clare
Australia, Southport
Gold Coast Health
Australia, Southport
Menzies Health Institute Queensland
Bost, Nerolie F.
Australia, Southport
Gold Coast Health
Australia, Brisbane
State Wide Emergency Department Network
Shiels, Sue
Australia, Brisbane
Logan Hospital
Statistics
Citations: 10
Authors: 10
Affiliations: 9
Identifiers
Doi:
10.1111/imj.12202
ISSN:
14440903
e-ISSN:
14455994
Research Areas
Health System And Policy
Study Design
Cross Sectional Study