Emergency Admissions and Elective Surgery Waiting Times

Abstract

An average patient waits between 2 and 3 months for an elective procedure in Australian public hospitals. Approximately 60% of all admissions occur through an emergency department, and bed competition from emergency admission provides one path by which waiting times for elective procedures may be lengthened. In this article, we investigated the extent to which public hospital waiting times are affected by the volume of emergency admissions and whether there is a differential impact by elective patient payment status. The latter has equity implications if the potential health cost associated with delayed treatment falls on public patients with lower ability to pay. Using annual data from public hospitals in the state of New South Wales, we found that, for a given available bed capacity, a one standard deviation increase in a hospital's emergency admissions lengthens waiting times by 19 days on average. However, paying (private) patients experience no delay overall. In fact, for some procedures, higher levels of emergency admissions are associated with lower private patient waiting times. Copyright © 2012 John Wiley & Sons, Ltd.

Investigating the link between medical urgency and hospital efficiency – Insights from the German hospital market

“…elective cases increased by only 1.4% [3]. Similar patterns can be observed in other countries, such as Australia, the United Kingdom, and the United States [4,5]. In contrast to elective cases, which can usually be pre-arranged and are therefore highly predictable, demand for emergency cases is less predictable [3,6].…”

“…We used two hospital outputs: (1) inpatient cases and (2) outpatient cases, which constitute the most important outputs for general care hospitals [34] and are used frequently in hospital efficiency studies [8]. Regarding inpatient cases, it is important to adjust for case severity because not all patients need the same level of treatment and attention 4 [40]. Following prior research [41][42][43], we used the case mix adjustment based on the relative length of stay (LOS) for groups of hospital diagnoses as proposed by Herr [44].…”

“…In the event of capacity constraints, short-notice prioritizations might lead to inefficiencies due to canceled or postponed non-urgent surgeries [14]. This, in combination with bed competition from emergency admissions, has been shown to result in longer hospital stays or inpatient waiting times for elective cases [4]. Moreover, differences in the predictability of elective and medically urgent cases might be pivotal in the context of efficiency.…”

Overestimation of health urgency as a cause for emergency services inappropriate use: Insights from an exploratory economics experiment in Portugal

“…Inappropriate use is thus seen to compromise efficient EDs operations, and to increase the overall cost of the system relative to having a general practitioner handle the case (Dale, Lang, Roberts, Green, & Glucksman, ). Moreover, it can also hamper the timely treatment of serious medical conditions at emergency care services (IOM ) and can increase waiting times for elective surgeries due to increased bed competition (Johar, Jones, & Savage, ).…”

The quality of life of people who have chronic wounds and who self‐treat

“…Although this effect has been previously reported among wound care recipients (Brod, 1998;Hopkins et al, 2006;Ribu & Wahl, 2004;Wellborn & Moceri, 2014), major efforts to improve this situation have been lacking. In Australia, efforts have tended to focus on improving the time that patients wait for once only episodes in acute care, such as elective surgery and emergency department treatment (Johar, Jones, & Savage, 2015). Again, if patient-centred metrics and outcome measures were prominent in community care settings, this issue could be better understood and addressed.…”