ArticleEmergency medicine journal : EMJ2019
Exploring the characteristics, acuity and management of adult ED patients at night-time.
Article in Emergency medicine journal : EMJ, 2019. 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.
- Article
- Severity of Illness and Mortality According to Time of Admission to Intensive Care.Acta anaesthesiologica Scandinavica · 2026Article
- Factors associated with hospitalization or surgery for abdominal pain: a retrospective study.Internal and emergency medicine · 2026Article
- Fractured Neck of Femur Clinical Pathway Use in Tasmanian Emergency Departments: A Retrospective Study.Emergency medicine Australasia : EMA · 2025Article
- Article
- Variation in Emergency Department Physician Admitting Practices and Subsequent Mortality.JAMA internal medicine · 2025Article
- Rethinking non-urgent EMS conveyance to ED during night-time - a pilot study in Southwest Finland.BMC emergency medicine · 2023Article
- Using machine-learning risk prediction models to triage the acuity of undifferentiated patients entering the emergency care system: a systematic review.Diagnostic and prognostic research · 2020Article
- Epidemiology of visits and predictors of admission at an obstetrics and gynecology emergency room in Saudi Arabia: Implications for women's health services in primary care.Women's health (London, England)Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesED care is required for acutely unwell and injured patients 24 hours a day, 7 days a week. The aim of this study was to compare characteristics and activity of type 1 ED attendances according to whether their time of arrival was during the day (08:00-18:00) or at night (18:00-08:00).
methodsHospital Episode Statistics (HES) data from NHS Digital for all A&E and admitted patient care activity provided by all acute (not mental health or primary care) NHS hospital trusts in Yorkshire and Humber (1 April 2011 to 31 March 2014) for adult patients were analysed. Adjusted linear and logistic regression was used to model the data.
resultsAdjusted regression analysis results show that patients who attended ED at night waited an extra 18.76 (95% CI 18.62 to 18.89) min to be seen by a clinician. They also spent an additional 13.64 (95% CI 13.47 to 13.81) min total in ED. Patients who attended at night were OR 2.20 (95% CI 2.17 to 2.23) times more likely to leave without being seen. They were also OR 1.26 (95% CI 1.25 to 1.27) times more likely to re-attend the ED and were OR 1.20 (95% CI 1.19 to 1.21) times more likely to present with non-urgent conditions. Overnight patients were more likely to be admitted to hospital, OR 1.09 (95% CI 1.09 to 1.10) times, however, those admitted were more likely to have a short-stay admission.
conclusionThere is an 'overnight effect' of patients attending EDs. Patients wait longer, leave without being seen, attend with non-urgent problems and are more likely to be admitted for a short stay. Further work is required to identify the potential underlying causes of these differences.
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