Hospital characteristics affecting potentially avoidable emergency admissions: National ecological study. (November 2013)

• Record Type: Journal Article
• Authors: O'Cathain, A; Knowles, E; Maheswaran, R; Turner, J; Hirst, E; Goodacre, S; Pearson, T; Nicholl, J
• Is Part Of: Health services management research. Volume 26:Number 4(2013)
• Page Start: 110
• Page End: 118
• Publication Date: 2013-11
• Subjects: access and evaluation -- emergency treatment -- health care quality -- variation analysis; Public health administration -- Research -- Periodicals; Public health administration -- Study and teaching (Higher) -- Periodicals; Health services administration -- Research -- Periodicals; Health services administration -- Study and teaching (Higher) -- Periodicals; 362.1072
• DOI: 10.1177/0951484814525357
• Languages: English
• ISSNs: 0951-4848

Abstract

Some emergency admissions can be avoided if acute exacerbations of health problems are managed by emergency and urgent care services without resorting to admission to a hospital bed. In England, these services include hospitals, emergency ambulance, and a range of primary and community services. The aim was to identify whether characteristics of hospitals affect potentially avoidable emergency admission rates. An age-sex adjusted rate of admission for 14 conditions rich in avoidable emergency admissions was calculated for 129 hospitals in England for 2008–2011. Twenty-two per cent (3, 273, 395/14, 998, 773) of emergency admissions were classed as potentially avoidable, with threefold variation between hospitals. Explanatory factors of this variation included those which hospital managers could not control (demand for hospital emergency departments) and those which they could control (supply in terms of numbers of acute beds in the hospital, and management of non-emergency and emergency patients within the hospital). Avoidable admission rates were higher for hospitals with higher emergency department attendance rates, higher numbers of acute beds per 1000 catchment population and higher conversion rates from emergency department attendance to admission. Hospital managers may be able to reduce avoidable emergency admissions by reducing supply of acute beds and conversion rates from emergency department attendance.