ArticleBMJ open2012
Reductions in hospital admissions and mortality rates observed after integrating emergency care: a natural experiment.
Article in BMJ open, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The effects of integrated care: a systematic review of UK and international evidence.BMC health services research · 2018Pooled it
- Emergency care in 59 low- and middle-income countries: a systematic review.Bulletin of the World Health Organization · 2015Pooled it
- Estimating the impact of discharge to nursing home on readmission and mortality: a propensity score matched analysis.BMC geriatrics · 2026Article
- Impact of hospitalist care model on patient outcomes in acute medical unit: a retrospective cohort study.BMJ open · 2023Article
- Article
- Effectiveness of clinical criteria in directing patient flow from the emergency department to a medical assessment unit in Queensland, Australia: a retrospective chart review of hospital administrative data.BMC health services research · 2021Article
- Impact of emergency care centralisation on mortality and efficiency: a retrospective service evaluation.Emergency medicine journal : EMJ · 2020Article
- A qualitative study exploring the factors influencing admission to hospital from the emergency department.BMJ open · 2017Article
- Epidemiology of injuries and outcomes among trauma patients receiving prehospital care at a tertiary teaching hospital in Kigali, Rwanda.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2016Article
- Developing metrics for emergency care research in low- and middle-income countries.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesReducing emergency admissions is a priority for the NHS. A single hospital's emergency care system was reorganised with the principles of front-loaded investigations, integration of specialties, reduced duplication, earlier decision making by senior clinicians and a combined emergency assessment area. The authors relocated our Medical Assessment Unit into our emergency department in 2006. The authors evaluated changes in admissions and mortality before and after 2006, compared with other similar hospitals.
designQuasi-experimental before and after study using routinely collected data. SETTING AND
participants1 acute hospital in England, the intervention site, was compared with 23 other English hospitals between 2001 and 2009. OUTCOME MEASURES: Our outcome measures were hospital standardised mortality ratios (HSMRs) for non-elective admissions and standardised admission ratios (SARs).
resultsThe authors observed a statistically and clinically significant decrease in HSMR and SAR. The intervention hospital had the lowest HSMR and SAR of all the hospitals in our sample. This was statistically significant, p=0.0149 and p=0.0002, respectively.
conclusionIntegrating emergency care in one location is associated with a meaningful reduction in mortality and emergency admissions to hospital.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.