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Exploring the characteristics, acuity and management of adult ED patients at night-time

OBJECTIVES: ED care is required for acutely unwell and injured patients 24 hours a day, 7 days a week. The aim of this study was to compare characteristics and activity of type 1 ED attendances according to whether their time of arrival was during the day (08:00–18:00) or at night (18:00–08:00). MET...

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Autores principales: Simpson, Rebecca, Croft, Susan, O’Keeffe, Colin, Jacques, Richard, Stone, Tony, Ahmed, Nisar, Mason, Suzanne M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6818519/
https://www.ncbi.nlm.nih.gov/pubmed/31362935
http://dx.doi.org/10.1136/emermed-2018-208248
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author Simpson, Rebecca
Croft, Susan
O’Keeffe, Colin
Jacques, Richard
Stone, Tony
Ahmed, Nisar
Mason, Suzanne M
author_facet Simpson, Rebecca
Croft, Susan
O’Keeffe, Colin
Jacques, Richard
Stone, Tony
Ahmed, Nisar
Mason, Suzanne M
author_sort Simpson, Rebecca
collection PubMed
description OBJECTIVES: ED care is required for acutely unwell and injured patients 24 hours a day, 7 days a week. The aim of this study was to compare characteristics and activity of type 1 ED attendances according to whether their time of arrival was during the day (08:00–18:00) or at night (18:00–08:00). METHODS: Hospital Episode Statistics (HES) data from NHS Digital for all A&E and admitted patient care activity provided by all acute (not mental health or primary care) NHS hospital trusts in Yorkshire and Humber (1 April 2011 to 31 March 2014) for adult patients were analysed. Adjusted linear and logistic regression was used to model the data. RESULTS: Adjusted regression analysis results show that patients who attended ED at night waited an extra 18.76 (95% CI 18.62 to 18.89) min to be seen by a clinician. They also spent an additional 13.64 (95% CI 13.47 to 13.81) min total in ED. Patients who attended at night were OR 2.20 (95% CI 2.17 to 2.23) times more likely to leave without being seen. They were also OR 1.26 (95% CI 1.25 to 1.27) times more likely to re-attend the ED and were OR 1.20 (95% CI 1.19 to 1.21) times more likely to present with non-urgent conditions. Overnight patients were more likely to be admitted to hospital, OR 1.09 (95% CI 1.09 to 1.10) times, however, those admitted were more likely to have a short-stay admission. CONCLUSION: There is an ‘overnight effect’ of patients attending EDs. Patients wait longer, leave without being seen, attend with non-urgent problems and are more likely to be admitted for a short stay. Further work is required to identify the potential underlying causes of these differences.
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spelling pubmed-68185192019-11-12 Exploring the characteristics, acuity and management of adult ED patients at night-time Simpson, Rebecca Croft, Susan O’Keeffe, Colin Jacques, Richard Stone, Tony Ahmed, Nisar Mason, Suzanne M Emerg Med J Short Report OBJECTIVES: ED care is required for acutely unwell and injured patients 24 hours a day, 7 days a week. The aim of this study was to compare characteristics and activity of type 1 ED attendances according to whether their time of arrival was during the day (08:00–18:00) or at night (18:00–08:00). METHODS: Hospital Episode Statistics (HES) data from NHS Digital for all A&E and admitted patient care activity provided by all acute (not mental health or primary care) NHS hospital trusts in Yorkshire and Humber (1 April 2011 to 31 March 2014) for adult patients were analysed. Adjusted linear and logistic regression was used to model the data. RESULTS: Adjusted regression analysis results show that patients who attended ED at night waited an extra 18.76 (95% CI 18.62 to 18.89) min to be seen by a clinician. They also spent an additional 13.64 (95% CI 13.47 to 13.81) min total in ED. Patients who attended at night were OR 2.20 (95% CI 2.17 to 2.23) times more likely to leave without being seen. They were also OR 1.26 (95% CI 1.25 to 1.27) times more likely to re-attend the ED and were OR 1.20 (95% CI 1.19 to 1.21) times more likely to present with non-urgent conditions. Overnight patients were more likely to be admitted to hospital, OR 1.09 (95% CI 1.09 to 1.10) times, however, those admitted were more likely to have a short-stay admission. CONCLUSION: There is an ‘overnight effect’ of patients attending EDs. Patients wait longer, leave without being seen, attend with non-urgent problems and are more likely to be admitted for a short stay. Further work is required to identify the potential underlying causes of these differences. BMJ Publishing Group 2019-09 2019-07-30 /pmc/articles/PMC6818519/ /pubmed/31362935 http://dx.doi.org/10.1136/emermed-2018-208248 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Short Report
Simpson, Rebecca
Croft, Susan
O’Keeffe, Colin
Jacques, Richard
Stone, Tony
Ahmed, Nisar
Mason, Suzanne M
Exploring the characteristics, acuity and management of adult ED patients at night-time
title Exploring the characteristics, acuity and management of adult ED patients at night-time
title_full Exploring the characteristics, acuity and management of adult ED patients at night-time
title_fullStr Exploring the characteristics, acuity and management of adult ED patients at night-time
title_full_unstemmed Exploring the characteristics, acuity and management of adult ED patients at night-time
title_short Exploring the characteristics, acuity and management of adult ED patients at night-time
title_sort exploring the characteristics, acuity and management of adult ed patients at night-time
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6818519/
https://www.ncbi.nlm.nih.gov/pubmed/31362935
http://dx.doi.org/10.1136/emermed-2018-208248
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