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Emerg Med Australas. 2017 May 24. doi: 10.1111/1742-6723.12808. [Epub ahead of print]
Influenza-associated delays in patient throughput and premature patient departure in emergency departments in New South Wales, Australia: A time series analysis.
Muscatello DJ1, Bein KJ2, Dinh MM2,3.
Author information
Abstract
OBJECTIVES:
Influenza outbreaks cause overcrowding in EDs. We aimed to quantify the impact of influenza on the National Emergency Access Targets and premature patient departure in New South Wales, Australia.
METHODS:
This was a retrospective observational study of 11 million presentations to 115 hospitals during 2010-2014, using routinely collected administrative records. A time series generalised additive regression model was used to assess the correlation between weekly influenza activity and the weekly proportion of patients leaving the ED in >4 h and the proportion that departed before commencing or completing treatment ('did not wait'), after controlling for background winter and holiday effects.
RESULTS:
During 2011-2014, peak annual circulating influenza was associated with the peak weekly proportion of presentations that left in >4 h. The maximum estimated absolute weekly change in that proportion was 3.88 (95% confidence interval 3.02-4.74) percentage points in 2014. For presentations that did not wait, influenza circulation was associated with statistically significant increases in all years, with a maximum weekly value of 2.68 (95% confidence interval 2.31-3.06) percentage points in 2012.
CONCLUSIONS:
Circulating influenza was associated with sustained increases and peaks in delayed patient throughput and premature patient departures. Influenza surveillance information may assist with development of health system and hospital workforce planning and bed management activities.
? 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
KEYWORDS:
influenza; overcrowding; performance; time series analysis
PMID: 28544364 DOI: 10.1111/1742-6723.12808
Influenza-associated delays in patient throughput and premature patient departure in emergency departments in New South Wales, Australia: A time series analysis.
Muscatello DJ1, Bein KJ2, Dinh MM2,3.
Author information
Abstract
OBJECTIVES:
Influenza outbreaks cause overcrowding in EDs. We aimed to quantify the impact of influenza on the National Emergency Access Targets and premature patient departure in New South Wales, Australia.
METHODS:
This was a retrospective observational study of 11 million presentations to 115 hospitals during 2010-2014, using routinely collected administrative records. A time series generalised additive regression model was used to assess the correlation between weekly influenza activity and the weekly proportion of patients leaving the ED in >4 h and the proportion that departed before commencing or completing treatment ('did not wait'), after controlling for background winter and holiday effects.
RESULTS:
During 2011-2014, peak annual circulating influenza was associated with the peak weekly proportion of presentations that left in >4 h. The maximum estimated absolute weekly change in that proportion was 3.88 (95% confidence interval 3.02-4.74) percentage points in 2014. For presentations that did not wait, influenza circulation was associated with statistically significant increases in all years, with a maximum weekly value of 2.68 (95% confidence interval 2.31-3.06) percentage points in 2012.
CONCLUSIONS:
Circulating influenza was associated with sustained increases and peaks in delayed patient throughput and premature patient departures. Influenza surveillance information may assist with development of health system and hospital workforce planning and bed management activities.
? 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
KEYWORDS:
influenza; overcrowding; performance; time series analysis
PMID: 28544364 DOI: 10.1111/1742-6723.12808