Process and Systems: A cohort study to evaluate the impact of service centralisation for emergency admissions with acute heart failure

Wilkinson, Chris, Thomas, Honey, McMeekin, Peter and Price, Chris (2019) Process and Systems: A cohort study to evaluate the impact of service centralisation for emergency admissions with acute heart failure. Future Healthcare Journal, 6 (1). pp. 41-46. ISSN 2514-6645

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Official URL: https://doi.org/10.7861/futurehosp.6-1-41

Abstract

The aim of our study was to describe the impact of emergency care centralisation on unscheduled admissions with a primary discharge diagnosis of acute heart failure (HF). We carried out a retrospective cohort study of HF admissions 1 year before and 1 year after centralisation of three accident and emergency departments into one within a single large NHS trust. Outcomes included mortality, length of stay, readmissions, specialist inpatient input and follow-up, and prescription rates of stabilising medication. Baseline characteristics were similar for 211 patients before and for 307 following reconfiguration. Median length of stay decreased from 8 to 6 days (p=0.020) without an increase in readmissions (4.7% versus 4.2%, p=0.813). The proportion with specialist follow-up increased (60% to 72%, p=0.036). There was a trend towards decreased mortality (32.2% versus 27.7% at 90 days; p=0.266). Contact with the cardiology team was associated with decreased mortality. In conclusion, centralisation of specialist emergency care was associated with greater service efficiency and a trend towards reduced mortality.

Item Type: Article
Uncontrolled Keywords: Heart failure, service reconfiguration, centralisation, emergency care
Subjects: A400 Clinical Dentistry
B700 Nursing
B800 Medical Technology
B900 Others in Subjects allied to Medicine
Department: Faculties > Health and Life Sciences > Nursing, Midwifery and Health
Depositing User: Elena Carlaw
Date Deposited: 06 Jan 2020 16:15
Last Modified: 15 Feb 2020 03:30
URI: http://nrl.northumbria.ac.uk/id/eprint/41836

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