Variation in attendance at emergency departments in England across local areas: A system under unequal pressure.

Autor: Jacob N; Centre for Health Economics, University of York, United Kingdom., Chalkley M; Centre for Health Economics, University of York, United Kingdom., Santos R; Centre for Health Economics, University of York, United Kingdom. Electronic address: rita.santos@york.ac.uk., Siciliani L; Centre for Health Economics, University of York, United Kingdom; Department of Economics and Related Studies, University of York, United Kingdom.
Jazyk: angličtina
Zdroj: Health policy (Amsterdam, Netherlands) [Health Policy] 2024 Dec; Vol. 150, pp. 105186. Date of Electronic Publication: 2024 Oct 22.
DOI: 10.1016/j.healthpol.2024.105186
Abstrakt: Background: Crowding in Accident and Emergency Departments (AEDs) and long waiting times are critical issues contributing to adverse patient outcomes and system inefficiencies. These challenges are exacerbated by varying levels of AED attendance across different local areas, which may reflect underlying disparities in primary care provision and population characteristics.
Method: We used regression analysis to determine how much variation across local areas in England of attendance at emergency departments remained after controlling for population risk factors and alternative urgent care provision.
Findings: There is substantial residual variation of the order of 3 to 1 (highest to lowest) in per person attendance rate across different areas. This is not related to in-hospital capacity as proxied by the per person number of hospital emergency doctors in an area.
Conclusion: Some areas in England have emergency departments that are under much greater pressure than others, and this cannot be explained in terms of their population characteristics or the availability of alternative treatment options. It is imperative to better understand the drivers of this variation so that effective interventions to address utilisation can be designed.
Competing Interests: Declaration of competing interest None.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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