ArticleBMJ open2016
Impact of integrated health system changes, accelerated due to an earthquake, on emergency department attendances and acute admissions: a Bayesian change-point analysis.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 17 citations in OpenAlex.
- Emergency Response and Clinical Insights from a Non-Epicenter Hospital during the 2023 Turkey-Syria Earthquake: A Retrospective Analysis.Medical science monitor : international medical journal of experimental and clinical research · 2023Article
- Carer distress among community living older adults with complex needs in the pre- and post-COVID-19 era: a national population study.Scientific reports · 2022Article
- Changes in patient admissions after the 2015 Earthquake: a tertiary hospital-based study in Kathmandu, Nepal.Scientific reports · 2020Article
- Hearing ability is not a risk factor for admission to aged residential care of older persons in New Zealand.Scientific reports · 2019Article
- Hospital avoidance: an integrated community system to reduce acute hospital demand.Primary health care research & development · 2019Article
- Psychosocial Management Before, During, and After Emergencies and Disasters-Results from the Kobe Expert Meeting.International journal of environmental research and public health · 2019Article
- Transforming primary care: scoping review of research and practice.Journal of integrated care (Brighton, England) · 2018Article
- Evaluating Google, Twitter, and Wikipedia as Tools for Influenza Surveillance Using Bayesian Change Point Analysis: A Comparative Analysis.JMIR public health and surveillance · 2016Article
- The "Iron Triangle" of Healthcare Services: Evaluating an Integrated Healthcare Alliance's Impact on Primary Care in Shenzhen, China.International journal of integrated careArticle
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo chart emergency department (ED) attendance and acute admission following a devastating earthquake in 2011 which lead to Canterbury's rapidly accelerated integrated health system transformations.
designInterrupted time series analysis, modelling using Bayesian change-point methods, of ED attendance and acute admission rates over the 2008-2014 period.
settingED department within the Canterbury District Health Board; with comparison to two other district health boards unaffected by the earthquake within New Zealand.
participantsCanterbury's health system services ∼500 000 people, with around 85 000 ED attendances and 37 000 acute admissions per annum.
main outcome measuresDe-seasoned standardised population ED attendance and acute admission rates overall, and stratified by age and sex, compared before and after the earthquake.
resultsAnalyses revealed five global patterns: (1) postearthquake, there was a sudden and persisting decrease in the proportion of the population attending the ED; (2) the growth rate of ED attendances per head of population did not change between the pre-earthquake and postearthquake periods; (3) postearthquake, there was a sudden and persisting decrease in the proportion of the population admitted to hospital; (4) the growth rate of hospital admissions per head of the population declined between pre-earthquake and postearthquake periods and (5) the most dramatic reduction in hospital admissions growth after the earthquake occurred among those aged 65+ years. Extrapolating from the projected and fitted deseasoned rates for December 2014, ∼676 (16.8%) of 4035 projected hospital admissions were avoided.
conclusionsWhile both necessarily and opportunistically accelerated, Canterbury's integrated health systems transformations have resulted in a dramatic and sustained reduction in ED attendances and acute hospital admissions. This natural intervention experiment, triggered by an earthquake, demonstrated that integrated health systems with high quality out-of-hospital care models are likely to successfully curb growth in acute hospital demand, nationally and internationally.
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