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• W3022921046 abstract "<h3>Objective</h3> To investigate factors associated with unscheduled admission following presentation to emergency departments (EDs) at three hospitals in England. <h3>Design and setting</h3> Cross-sectional analysis of attendance data for patients from three urban EDs in England: a large teaching hospital and major trauma centre (site 1) and two district general hospitals (sites 2 and 3). Variables included patient age, gender, ethnicity, deprivation score, arrival date and time, arrival by ambulance or otherwise, a variety of ED workload measures, inpatient bed occupancy rates and admission outcome. Coding inconsistencies in routine ED data used for this study meant that diagnosis could not be included. <h3>Outcome measure</h3> The primary outcome for the study was unscheduled admission. <h3>Participants</h3> All adults aged 16 and older attending the three inner London EDs in December 2013. Data on 19 734 unique patient attendances were gathered. <h3>Results</h3> Outcome data were available for 19 721 attendances (>99%), of whom 6263 (32%) were admitted to hospital. Site 1 was set as the baseline site for analysis of admission risk. Risk of admission was significantly greater at sites 2 and 3 (adjusted OR (AOR) relative to site 1 for site 2 was 1.89, 95% CI 1.74 to 2.05, p<0.001) and for patients of black or black British ethnicity (AOR 1.29, 1.16 to 1.44, p<0.001). Deprivation was strongly associated with admission. Analysis of departmental and hospital-wide workload pressures gave conflicting results, but proximity to the “4-hour target” (a rule that limits patient stays in EDs to 4 hours in the National Health Service in England) emerged as a strong driver for admission in this analysis (AOR 3.61, 95% CI 3.30 to 3.95, p<0.001). <h3>Conclusion</h3> This study found statistically significant variations in odds of admission between hospital sites when adjusting for various patient demographic and presentation factors, suggesting important variations in ED-level and clinician-level behaviour relating to admission decisions. The 4-hour target is a strong driver for emergency admission." @default.
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• W3022921046 date "2017-06-01" @default.
• W3022921046 modified "2023-09-27" @default.
• W3022921046 title "Risk factors for admission at three urban emergency departments in England: a cross-sectional analysis of attendances over 1 month" @default.
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• W3022921046 doi "https://doi.org/10.1136/bmjopen-2016-011547" @default.
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