Type

Journal Article

Authors

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

Subjects

Economics

Topics
ireland time series time series analysis emergency department reconfiguration health service executive trolley numbers impact analysis regional emergency department

An interrupted time-series analysis of the impact of emergency department reconfiguration on regional emergency department trolley numbers in Ireland from 2005 to 2015 (2019)

Abstract Objectives: To understand the impact of emergency department (ED) reconfiguration on the number of patients waiting for hospital beds on trolleys in the remaining EDs in four geographical regions in Ireland using time-series analysis. Setting: EDs in four Irish regions; the West, North-East, South and Mid-West from 2005 to 2015. Participants: All patients counted as waiting on trolleys in an ED for a hospital bed in the study hospitals from 2005 to 2015. Intervention: The system intervention was the reconfiguration of ED services, as determined by the Department of Health and Health Service Executive. The timing of these interventions varied depending on the hospital and region in question. Results: Three of the four regions studied experienced a significant change in ED trolley numbers in the 12-month post-ED reconfiguration. The trend ratio before and after the intervention for these regions was as follows: North-East incidence rate ratio (IRR) 2.85 (95% CI 2.04 to 3.99, p<0.001), South IRR 0.68 (95% CI 0.51 to 0.89, p=0.006) and the Mid-West IRR 0.03 (95% 1.03 to 2.03, p=0.03). Two of these regions, the South and the Mid-West, displayed a convergence between the observed and expected trolley numbers in the 12-month post-reconfiguration. The North-East showed a much steeper increase, one that extended beyond the 12-month period post-ED reconfiguration. Conclusions: Findings suggest that the impacts of ED reconfiguration on regional level ED trolley trends were either non-significant or caused a short-term shock which converged on the pre-reconfiguration trend over the following 12 months. However, the North-East is identified as an exception due to increased pressures in one regional hospital, which caused a change in trend beyond the 12-month post reconfiguration.
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Full list of authors on original publication

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

Experts in our system

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