Type

Journal Article

Authors

John Browne
Conor Foley
Claire Buckley
Orla Healy
Paul Corcoran
Anthony P. Fitzgerald
Brenda Lynch

Subjects

Medicine & Nursing

Topics
regional variations guidelines health systems england distance stroke acute myocardial infarction emergency care wales mortality reconfiguration deprivation

Case fatality ratios for serious emergency conditions in the Republic of Ireland: a longitudinal investigation of trends over the period 2002-2014 using joinpoint analysis (2018)

Abstract Background: In the past decade, the Republic of Ireland has undertaken significant reconfiguration programmes to improve emergency services. During this time the public healthcare system experienced a large real decrease in resources. This study assesses national and regional population outcomes over the period 2002–2014, and whether changes coincide with system reconfiguration and the financial restrictions imposed by the 2008 recession. Methods: Case fatality ratios (CFRs) were constructed for emergency conditions for 2002–2014. Total emergency conditions and individual condition trends were analysed nationally using joinpoint analysis. National results informed the investigation of trends at a regional and county level using an inverse standard error weighted generalised linear model with a log link to construct funnel plots. County-level CFRs were compared for the first and last 3 years of the period to further investigate the changes to county results over the 13 year period, specifically in comparison to the national-level CFR. Results: Nationally, there was an annual fall in CFRs (2.1%). The decline was faster from 2002 to 2007 (annual percentage change = − 3.4; 95% CI-4.4, − 2.4), compared to 2007–2014 (annual percentage change = − 1.2; 95% CI -1.9, − 0.5). The South-East had a lower rate of decrease and the West had a higher rate. Cross sectional analysis of two periods (2002–2004 and 2012–2014) showed high consistency in the counties performance relative to the national CFR in both periods. Conclusion: Change in the national trend coincided with the onset of economic stress on the public health system. Attributing the decline in CFR improvement to economic factors is weakened by the uneven nature of the trend change. No distinct pattern of change was identified among regions which underwent substantial reconfiguration of emergency services.
Collections Ireland -> University College Cork -> Public Health
Ireland -> University College Cork -> College of Medicine and Health
Ireland -> University College Cork -> Public Health - Journal Articles

Full list of authors on original publication

John Browne, Conor Foley, Claire Buckley, Orla Healy, Paul Corcoran, Anthony P. Fitzgerald, Brenda Lynch

Experts in our system

1
John A Browne
University College Dublin
Total Publications: 73
 
2
C Foley
University College Cork
Total Publications: 11
 
3
Claire M. Buckley
University College Cork
Total Publications: 40
 
4
Orla Healy
University College Cork
Total Publications: 11
 
5
Paul Corcoran
University College Cork
Total Publications: 90
 
6
Anthony P Fitzgerald
University College Cork
Total Publications: 78
 
7
Brenda Lynch
University College Cork
Total Publications: 8