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Journal of General Internal Medicine

, Volume 33, Issue 10, pp 1623–1625 | Cite as

Rising Emergency Admission and Readmission Rates—a Retrospective Study of Demographic and Socio-economic Factors

  • Declan Byrne
  • Richard Conway
  • Seán Cournane
  • Deirdre O’Riordan
  • Bernard Silke
Concise Research Reports

Introduction

Emergency hospital admissions have been rising over time1; the precise reasons have been debated. A lowered threshold to admit, or changing demographic population structures have been proposed as explanations.2 Our institution established an acute medical admission unit in 2002 and its performance in relation to clinical outcomes has been well described.3 We have developed a risk score that is related exponentially to 30-day in-hospital mortality; this estimates acute illness severity and case complexity using both laboratory (multiple-variable fractional polynomial method4) and blood culture data supplemented by case complexity estimates calculated from discharge codes (ICD9/ICD10)—Charlson Comorbidity Index and the Chronic Disabling Score. From such determinants, we can assess temporal change in case acuity or complexity, and relate these to admission thresholds.5Our study’s purpose was to examine16 years of acute medical admissions (2002–2017) at St. James’ Hospital,...

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

References

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    Conway R, Byrne D, Cournane S, O’Riordan D, Silke B. Fifteen-year outcomes of an acute medical admission unit. Ir J Med Sci. 2018.  https://doi.org/10.1007/s11845-018-1789-y.CrossRefGoogle Scholar
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    Wyatt S, Child K, Hood A , Cooke M, Mohammed M. Changes in admission thresholds in English emergency departments. Emerg Med J. Published Online First: 12 September 2017.  https://doi.org/10.1136/emermed-2016-206213.CrossRefGoogle Scholar
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    Kelly ATC. The national deprivation index for health and health services research - update 2013. Small Area Health Research Unit, Department of Health and Primary Care: Trinity College Dublin; 2013.Google Scholar

Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  • Declan Byrne
    • 1
  • Richard Conway
    • 1
  • Seán Cournane
    • 2
  • Deirdre O’Riordan
    • 1
  • Bernard Silke
    • 1
  1. 1.Department of Internal Medicine St. James’s HospitalDublin 8Ireland
  2. 2.Medical Physics and Bioengineering DepartmentSt. Vincent’s University HospitalDublin 4Ireland

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