Bidmead, T., Goodacre, S., Maheswaran, R. et al. (1 more author) (2014) Factors influencing unspecified chest pain admission rates in England. Emergency Medicine Journal, 32 (6). 439 - 443. ISSN 1472-0205
Abstract
Background Unspecified chest pain is an important and potentially avoidable cause of emergency hospital admission. We aimed to examine inter-hospital variation in admission rates with unspecified chest pain and identify population characteristics, services and technologies that might explain this variation. Methods We used Hospital Episodes Statistics data from 152 acute trusts in England to calculate a direct standardised annual admission rate per 100 000 population for each trust. Regression analysis was used to identify factors explaining variation, first, using routinely available data relating to the hospital catchment area and service and then using responses to a survey of emergency department (ED) management. Results The best predictors of admission rate using routine data were total beds per 1000 population (p=0.001), rapid access chest pain clinic (RACPC) attendances per year (p<0.001) and percentage of households in poverty (p=0.01). Including data from 105/142 (74%) survey responses, the best predictors of admission rate were total beds (p<0.001), RACPC attendances (p=0.001), mean ED waiting time (p=0.049) and percentage of households in poverty (p<0.001). All associations were positive (higher variable predicts higher rate) except ED waiting time. We found no significant associations between factors relating to acute chest pain management and admission rate. Conclusions Hospitals with higher admission rates for unspecified chest pain have greater bed provision, more RACPC attendances and serve populations with a higher percentage of households in poverty. These findings may be explained by services responding to demand in populations with greater need. We found no evidence that chest pain management influenced admission rates.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2014 BMJ. This is an author produced version of a paper subsequently published in Emergency Medicine Journal. Uploaded in accordance with the publisher's self-archiving policy. |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 30 Jun 2015 10:49 |
Last Modified: | 30 Jul 2015 12:47 |
Published Version: | http://dx.doi.org/10.1136/emermed-2014-203678 |
Status: | Published |
Publisher: | BMJ Publishing Group |
Refereed: | Yes |
Identification Number: | 10.1136/emermed-2014-203678 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:87459 |