Characterising non-urgent users of the emergency department (ED): A retrospective analysis of routine ED data

The pressures of patient demand on emergency departments (EDs) continue to be reported worldwide, with an associated negative impact on ED crowding and waiting times. It has also been reported that a proportion of attendances to EDs in different international systems could be managed in settings suc...

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Bibliographic Details
Published in:PloS one 2018-02, Vol.13 (2), p.e0192855-e0192855
Main Authors: O'Keeffe, Colin, Mason, Suzanne, Jacques, Richard, Nicholl, Jon
Format: Article
Language:English
Subjects:
Adults
Analysis
Computer and Information Sciences
Departments
Emergency management
Emergency medical care
Emergency medical services
Emergency preparedness
Emergency services
Emergency vehicles
Engineering and Technology
Health care
Health care access
Hospital emergency services
Hospitals
Medical care utilization
Medicine and Health Sciences
Patients
People and Places
Primary care
Statistical analysis
Statistics
Time of use
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Summary:The pressures of patient demand on emergency departments (EDs) continue to be reported worldwide, with an associated negative impact on ED crowding and waiting times. It has also been reported that a proportion of attendances to EDs in different international systems could be managed in settings such as primary care. This study used routine ED data to define, measure and profile non-urgent ED attendances that were suitable for management in alternative, non-emergency settings. We undertook a retrospective analysis of three years of Hospital Episode and Statistics Accident Emergency (HES A&E) data for one large region in England, United Kingdom (April 1st 2011 to March 31st 2014). Data was collected on all adult (>16 years) ED attendances from each of the 19 EDs in the region. A validated process based definition of non-urgent attendance was refined for this study and applied to the data. Using summary statistics non-urgent attenders were examined by variables hypothesised to influence them as follows: age at arrival, time of day and day of week and mode of arrival. Odds ratios were calculated to compare non-urgent attenders between groups. There were 3,667,601 first time attendances to EDs, of which 554,564 were defined as non-urgent (15.1%). Non-urgent attendances were significantly more likely to present out of hours than in hours (OR = 1.19, 95% CI: 1.18 to 1.20, P
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0192855