ArticleBMC health services research2014
Variations and inter-relationship in outcome from emergency admissions in England: a retrospective analysis of Hospital Episode Statistics from 2005-2010.
Article in BMC health services research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Reporting of health-related quality of life in emergency laparotomy trials: a systematic review and narrative synthesis.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024Pooled it
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- Weekend admissions may be associated with poorer recording of long-term comorbidities: a prospective study of emergency admissions using administrative data.BMC health services research · 2018Article
- Feasibility of collecting retrospective patient reported outcome measures (PROMs) in emergency hospital admissions.Journal of patient-reported outcomes · 2018Article
- Feasibility of collecting and assessing patient-reported outcomes for emergency admissions: laparotomy for gastrointestinal conditions.BMJ open gastroenterology · 2018Article
- Common Sequences of Emergency Readmissions among High-Impact Users following AAA Repair.Surgery research and practice · 2018Article
- Trajectory Modelling to Assess Trends in Long-Term Readmission Rate among Abdominal Aortic Aneurysm Patients.Surgery research and practice · 2018Article
- Social Factors Determine the Emergency Medical Admission Workload.Journal of clinical medicine · 2017Article
- Hospital readmissions for COPD: a retrospective longitudinal study.NPJ primary care respiratory medicine · 2017Observational
- Predicting Outcomes in Emergency Medical Admissions Using a Laboratory Only Nomogram.Computational and mathematical methods in medicine · 2017Article
- Enhanced recovery after surgery: An opportunity to improve fractured neck of femur management.Annals of the Royal College of Surgeons of England · 2016Article
- Management and Outcomes of Esophageal Perforation: A National Study of 2,564 Patients in England.The American journal of gastroenterology · 2015Article
- Research activity and the association with mortality.PloS one · 2015Article
- Length of stay of COPD hospital admissions between 2006 and 2010: a retrospective longitudinal study.International journal of chronic obstructive pulmonary disease · 2015Article
- Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundThe quality of care delivered and clinical outcomes of care are of paramount importance. Wide variations in the outcome of emergency care have been suggested, but the scale of variation, and the way in which outcomes are inter-related are poorly defined and are critical to understand how best to improve services. This study quantifies the scale of variation in three outcomes for a contemporary cohort of patients undergoing emergency medical and surgical admissions. The way in which the outcomes of different diagnoses relate to each other is investigated.
methodsA retrospective study using the English Hospital Episode Statistics 2005-2010 with one-year follow-up for all patients with one of 20 of the commonest and highest-risk emergency medical or surgical conditions. The primary outcome was in-hospital all-cause risk-standardised mortality rate (in-RSMR). Secondary outcomes were 1-year all-cause risk-standardised mortality rate (1 yr-RSMR) and 28-day all-cause emergency readmission rate (RSRR).
results2,406,709 adult patients underwent emergency medical or surgical admissions in the groups of interest. Clinically and statistically significant variations in outcome were observed between providers for all three outcomes (p < 0.001). For some diagnoses including heart failure, acute myocardial infarction, stroke and fractured neck of femur, more than 20% of hospitals lay above the upper 95% control limit and were statistical outliers. The risk-standardised outcomes within a given hospital for an individual diagnostic group were significantly associated with the aggregated outcome of the other clinical groups.
conclusionsHospital-level risk-standardised outcomes for emergency admissions across a range of specialties vary considerably and cross traditional speciality boundaries. This suggests that global institutional infra-structure and processes of care influence outcomes. The implications are far reaching, both in terms of investigating performance at individual hospitals and in understanding how hospitals can learn from the best performers to improve outcomes.
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