ArticleBMJ open2017
A qualitative study exploring the factors influencing admission to hospital from the emergency department.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.
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Who cites it
37 citing papers in PubMed.
- Outcomes Following a Mental Health Care Intervention for Children in the Emergency Department: A Nonrandomized Clinical Trial.JAMA network open · 2025Trial
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- A work systems approach to characterizing emergency department disposition decision-making under low and high demand.Applied ergonomics · 2026Article
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- Factors associated with psychiatric admission from observation beds in the psychiatric emergency room.Frontiers in psychiatry · 2026Article
- Non-clinical factors influencing discharge and admission decisions in the emergency department: a focus group study among Israeli physicians.BMC emergency medicine · 2025Article
- Risk Factors for Hospital Admissions Among Emergency Department Patients: From Triage to Admission.The western journal of emergency medicine · 2025Article
- Bridging the Gaps in Atrial Fibrillation Management in the Emergency Department.Journal of cardiovascular development and disease · 2025Review
- The social experience of uncertainty: a qualitative analysis of emergency department care for suspected pneumonia for the design of decision support.BMC medical informatics and decision making · 2024Article
- Physician performance scores used to predict emergency department admission numbers and excessive admissions burden.BMJ health & care informatics · 2024Article
- Patient, caregiver and professional views on preventable emergency admissions of older patients, a multi-method study in three Dutch hospitals.BMC geriatrics · 2024Article
- Preventable hospitalizations through ED: does the number of hospital beds matter under the global budget in a single-payer system in Taiwan?Frontiers in public health · 2024Article
- Flow through the Emergency Department for Patients Presenting with Substance Use Disorder in Alberta, Canada.The western journal of emergency medicine · 2023Article
- Unnecessary hospitalisations and polypharmacy practices in Romania: A health system evaluation for strengthening primary health care.Journal of global health · 2023Article
- Article
- Incidence of moral hazards among health care providers in the implementation of social health insurance toward universal health coverage: evidence from rural province hospitals in Indonesia.Frontiers in public health · 2023Article
- Measuring the quality of mental health services from the patient perspective in China: psychometric evaluation of the Chinese version of the World Health Organization responsiveness performance questionnaire.Global health action · 2022Article
- [Risk management in the triage of emergency room patients to outpatient care : Manchester Triage System and CEReCo-blue as a tool for low-risk patient management in integrated emergency centers].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2022Article
- Short stay hospital admissions for an acutely unwell child: A qualitative study of outcomes that matter to parents and professionals.PloS one · 2022Article
- Prediction of admission to a low-resource sub-Saharan hospital by mental status, mobility and oxygen saturation recorded on arrival: a prospective observational study.Clinical medicine (London, England) · 2021Observational
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe number of emergency admissions to hospital in England and Wales has risen sharply in recent years and is a matter of concern to clinicians, policy makers and patients alike. However, the factors that influence this decision are poorly understood. We aimed to ascertain how non-clinical factors can affect hospital admission rates.
methodWe conducted semistructured interviews with 21 participants from three acute hospital trusts. Participants included 11 emergency department (ED) doctors, 3 ED nurses, 3 managers and 4 inpatient doctors. A range of seniority was represented among these roles. Interview questions were developed from key themes identified in a theoretical framework developed by the authors to explain admission decision-making. Interviews were recorded, transcribed and analysed by two independent researchers using framework analysis.
findingsDepartmental factors such as busyness, time of day and levels of senior support were identified as non-clinical influences on a decision to admit rather than discharge patients. The 4-hour waiting time target, while overall seen as positive, was described as influencing decisions around patient admission, independent of clinical need. Factors external to the hospital such as a patient's social support and community follow-up were universally considered powerful influences on admission. Lastly, the culture within the ED was described as having a strong influence (either negatively or positively) on the decision to admit patients.
conclusionMultiple factors were identified which go some way to explaining marked variation in admission rates observed between different EDs. Many of these factors require further inquiry through quantitative research in order to understand their influence further.
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