Factors influencing the costs of emergency medical admissions to an Irish teaching hospital

Moloney, E; Bennett, Kathleen; Silke, Bernard

doi:10.1007/s10198-006-0343-4

Cited by 14 publications

(4 citation statements)

References 28 publications

(29 reference statements)

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“…Persons with a psychiatric diagnosis present to the emergency department (ED) 5 times more often than persons without a psychiatric diagnosis, and these visits are associated with increased hospital costs (Brennan, Chan, Hsia, Wilson, & Castillo, 2014; Moloney, Bennett, & Silke, 2006; Williams et al, 2001). Patients requiring psychiatric care are often met with contempt by ED staff, who might deem their visit to be unnecessary or inappropriate (Sulzer, 2015; White, 2010).…”

Section: Introductionmentioning

confidence: 99%

Exploring the Experiences of Persons Who Frequently Visit the Emergency Department for Mental Health-Related Reasons

et al. 2017

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In this qualitative study, the experiences of persons who frequently visit the emergency department (ED) for mental health-related reasons were explored. Interpretive Description guided the design, and data were collected through interviews with 10 adults who made 12+ ED visits within a 1-year time frame (2015). Thematic analysis was used to analyze data inductively. The participants' experiences were described with the help of three themes emerging from the data: The Experience, The Providers, and Protective Factors. The participants felt compelled to come to hospital. For them, every visit was necessary, and dismissal of their needs by staff was interpreted as disrespect and prejudice. We noted differences in ED utilization patterns according to psychiatric diagnosis, and more research is needed to explore the phenomenon of frequent use by particular patient populations. Furthermore, health care providers implementing interventions designed to improve emergency care should consider tailored approaches rather than a one-size-fits-all strategy.

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Section: Introductionmentioning

confidence: 99%

Exploring the Experiences of Persons Who Frequently Visit the Emergency Department for Mental Health-Related Reasons

et al. 2017

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“…We have previously shown that the introduction of an AMAU speeded access to an acute medical service, and reduced costs by reducing LOS 6 7. Variations between consultants’ practice in the AMAU may reflect a genuine special interest bias, or absence of definitive guidelines for the management of common acute medical conditions 9.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, it is recognised that an acute hospital can expect regular bed shortages for emergency department patients when hospital bed occupancy rates exceed 85%, and periodic bed crises if hospital bed occupancy rises to 90% or more 4 5. We have previously reported how the introduction of an acute medical admissions unit (AMAU) facilitated speedier access from the emergency department to the acute medical service, and reduced hospital costs by decreasing length of stay (LOS) 6 7…”

mentioning

confidence: 99%

Effect of an acute medical admission unit on key quality indicators assessed by funnel plots

Moloney

Bennett²,

Silke

2007

Postgraduate Medical Journal

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Objective To determine the effect of the introduction of an acute medical admissions unit (AMAU) on key quality efficiency and outcome indicator comparisons between medical teams as assessed by funnel plots. Methods A retrospective analysis was performed of data relating to emergency medical patients admitted to St James' Hospital, Dublin between 1 January 2002 and 31 December 2004, using data on discharges from hospital recorded in the hospital in-patient enquiry system. The base year was 2002 during which patients were admitted to a variety of wards under the care of a named consultant physician. In 2003, two centrally located wards were reconfigured to function as an AMAU, and all emergency patients were admitted directly to this unit. The quality indicators examined between teams were length of stay (LOS) <30 days, LOS >30 days, and readmission rates. Results The impact of the AMAU reduced overall hospital LOS from 7 days in 2002 to 5 days in 2003/04 (p<0.0001). There was no change in readmission rates between teams over the 3 year period, with all teams displaying expected variability within control (95%) limits. Overall, the performance in LOS, both short term and long term, was significantly improved (p<0.0001), and was less varied between medical teams between 2002 and 2003/04. Conclusions Introduction of the AMAU improved performance among medical teams in LOS, both short term and long term, with no change in readmissions. Funnel plots are a powerful graphical technique for presenting quality performance indicator variation between teams over time.

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“…In recent years, repeated emergent hospitalization for patients with acute heart failure (HF) has become a cause for significant medical and economic burden [1][2][3][4]. It is well recognized that educating patients about early signs of HF exacerbation and providing them with early medical intervention in ambulant settings are important to prevent emergent rehospitalization [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Delay in seeking treatment before emergent heart failure readmission and its association with clinical phenotype

et al. 2020

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Background: Many patients with emergent heart failure (HF) readmission have a delay between symptom onset and hospitalization. The present study aimed to characterize the interval between symptom onset and hospitalization in patients being readmitted for HF and to compare the clinical phenotypes of patients with delay before emergent readmission with those who presented to the hospital earlier. Methods: Data for a total of 2073 consecutive patients was collected from the Tokyo CCU Network database; the patients were divided into delayed (those who sought medical help > 2 days after symptom onset; n = 271) and early groups (remaining patients; n = 1802), and their clinical characteristics and mode of presentation were compared. Results: Age, sex, and laboratory findings including brain natriuretic peptide and serum creatinine levels were not significantly different between the two groups. Patients in the delayed group had greater chronic fluid retention and symptoms not associated with respiratory failure, whereas those in the early group were more likely to have acute respiratory distress, faster heart and respiration rates, and higher systolic blood pressure. Conclusions: More than one in ten patients with HF readmission delay seeking treatment > 2 days after symptom onset. Patients who delayed seeking treatment showed the phenotype of chronic fluid retention, whereas those who presented to the hospital earlier had the phenotype of acute respiratory failure.

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Factors influencing the costs of emergency medical admissions to an Irish teaching hospital

Cited by 14 publications

References 28 publications

Exploring the Experiences of Persons Who Frequently Visit the Emergency Department for Mental Health-Related Reasons

Exploring the Experiences of Persons Who Frequently Visit the Emergency Department for Mental Health-Related Reasons

Effect of an acute medical admission unit on key quality indicators assessed by funnel plots

Delay in seeking treatment before emergent heart failure readmission and its association with clinical phenotype

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