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No more winter crisis? Forecasting daily bed requirements for emergency department admissions to hospital

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  • No more winter crisis? Forecasting daily bed requirements for emergency department admissions to hospital

    Eur J Emerg Med. 2017 Jan 25. doi: 10.1097/MEJ.0000000000000451. [Epub ahead of print]
    No more winter crisis? Forecasting daily bed requirements for emergency department admissions to hospital.

    Wargon M1, Brun-Ney D, Beaujouan L, Casalino E.
    Author information

    Abstract

    STUDY HYPOTHESIS:

    We hypothesized that age, calendar variables, and clinical influenza epidemics may have an impact on the number of daily through-emergency department (ED) hospitalizations. The aim of our study was to elaborate a pragmatic tool to predict the daily number of through-ED hospitalizations.
    METHODS:

    We carried out a prospective-observational study including data from 18 ED located in the Paris metropolitan area. Daily through-ED hospitalizations numbers from 2007 to 2010 were modelized to forecast the year 2011 using a general linear model by age groups (<75-years; ≥75-years) using calendar variables and influenza epidemics as explanatory variables. Lower and higher limits forecast with the 95% confidence interval of each explanatory variable were calculated.
    RESULTS:

    2 741 974 ED visits and 518 857 through-ED hospitalizations were included. We found a negative trend (-2.7%) for hospitalization visits among patients less than 75 years of age and an increased trend (+6.2%) for patients of at least 75 years of age. Calendar variables were predictors for daily hospitalizations for both age groups. Influenza epidemic period was not a predictor for hospitalizations in patients less than 75 years of age; among patients of at least 75 years of age, significant value was found only in models excluding months. When forecasting hospitalizations, 70% for patients less than 75 years of age and 66.8% for patients of at least 75 years of age of daily predicted values were included in the forecast limits.
    CONCLUSION:

    Daily number of emergency hospitalizations could be predicted on a regional basis using calendar variables with a low level of error. Forecasting through-ED hospitalizations requires to differentiate between elderly and younger patients, with a low impact of influenza epidemic periods in elders and absent in youngest patients.


    PMID: 28118319 DOI: 10.1097/MEJ.0000000000000451
    [PubMed - as supplied by publisher]
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