Understanding the distribution of A&E attendances and hospital admissions for the case managed population: A single case cross sectional study

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• 作者：Eloise Phillips^a ; ^{eloise.phillips@bcu.ac.uk} ; Sarahjane Jones^a ; ^{sarahjane.jones@bcu.ac.uk} ; Jessica Runacres^a ; ^{jessica.runacres@bcu.ac.uk} ; Maxine Lintern^b ; ^{maxine.lintern@bcu.ac.uk} ; Mark Radford^c ; ^{mark.radford@uhcw.nhs.uk}
• 关键词：Case management ; Long-term conditions ; Chronic disease management ; After-hours care ; Data accuracy
• 刊名：Applied Nursing Research
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：33
• 期：Complete
• 页码：24-29
• 全文大小：575 K
• 卷排序：33

文摘

To describe the characteristics of case-managed patients presenting at accident and emergency (A & E) and to explore the distribution of their attendances and admissions.BackgroundRecently, the UK Government announced extended-hours primary care provision in an effort to reduce the growing utilization of A & E. No evidence is available to understand the use of acute services by this high-risk patient group.MethodA cross-sectional design utilising routinely collected anonymsed A & E attendance and hospital admission data from 2010 to 2015.ResultsThe case-managed population is typically 70 years and older and most often arrive at A & E via emergency services and during the night (00:00–08:59). A large proportion are subsequently admitted having a statistically significant A & E conversion rate. No variables were predictive of admission.ConclusionThe high level of A&E conversion could indicate case-managed patients are presenting appropriately with acute clinical need. However, inadequate provision in primary-care could drive decisions for admitting vulnerable patients.