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Published VersionCC BY-NC-ND V4.0, Open Access
Journal article
Expanding emergency department capacity: a multisite study
Australian Health Review, Vol.38, pp.278-287
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 healthdata 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 less than 65 years, Australian Triage Scale (ATS) Category 1-3, diagnoses of circulatory or respiratory conditions and ED LOS less than 4 h. With additional capacity, the odds ratios for these predictors increased for age less than 65 years and ED LOS less than 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 andED LOS. To improve all service outcomes, when altering (increasing or decreasing) ED bed numbers, the whole healthcare system needs to be considered.
Details
- Title
- Expanding emergency department capacity: a multisite study
- Authors
- Julia L Crilly (Author) - Griffith UniversityGerben B Keijzers (Author) - Griffith UniversityVivienne C Tippett (Author) - Queensland University of TechnologyJohn A O'Dwyer (Author) - University of QueenslandMarianne Wallis (Author) - University of the Sunshine Coast - Faculty of Science, Health, Education and EngineeringJames F Lind (Author) - Griffith UniversityNerolie F Bost (Author) - Gold Coast HospitalMarilla A O'Dwyer (Author) - Royal Brisbane & Women's HospitalSue Shiels (Author) - Logan Hospital, Queensland Health
- Publication details
- Australian Health Review, Vol.38, pp.278-287
- Publisher
- C S I R O Publishing
- Date published
- 2014
- DOI
- 10.1071/AH13085
- ISSN
- 0156-5788; 0156-5788
- Copyright note
- Copyright © 2014 The Authors. This article is published under a CC-BY-NC-ND licence: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/deed.en_US).
- Organisation Unit
- School of Nursing, Midwifery and Paramedicine - Legacy
- Language
- English
- Record Identifier
- 99448963602621
- Output Type
- Journal article
- Research Statement
- false
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