Social Factors Determine the Emergency Medical Admission Workload
Abstract
:1. Introduction
2. Experimental Section
2.1. Background
2.2. Data Collection
2.3. Deprivation Indices
2.4. Risk Predictors
2.5. Statistical Methods
3. Results
3.1. Patient Demographics
3.2. Emergency Medical Patient Admission Characteristics
3.3. Deprivation Parameters and Admission Incidence Rates
3.4. Other Small Area Descriptors and the Admission Incidence Rates
3.5. Multivariable Model with Adjustment for Deprivation Index
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Factor | Level | Quintiles I/III | Quintiles IV/V | p-Value |
---|---|---|---|---|
N | 6150 | 56,219 | ||
Gender | Male | 2791 (45.4%) | 27,654 (49.2%) | <0.001 |
Female | 3359 (54.6%) | 28,565 (50.8%) | ||
Outcome | Alive | 5750 (93.5%) | 53,479 (95.1%) | <0.001 |
Died | 400 (6.5%) | 2740 (4.9%) | ||
Age, median (IQR) | 74.9 (58.3, 83.2) | 64.3 (45.1, 77.9) | <0.001 | |
Length of Stay (days) | 5.5 (2.4, 10.8) | 5.3 (2.3, 10.0) | <0.001 | |
Admission Rate * | 14.0 (7.7, 16.2) | 33.9 (25.8, 41.8) | <0.001 | |
Readmissions | 1.0 (0.0, 2.0) | 2.0 (0.0, 4.0) | <0.001 | |
Acute Illness Severity | 1 | 117 (2.1%) | 1373 (2.7%) | <0.001 |
2 | 261 (4.7%) | 3305 (6.4%) | ||
3 | 459 (8.2%) | 5973 (11.6%) | ||
4 | 726 (13.0%) | 8637 (16.8%) | ||
5 | 1156 (20.7%) | 10,454 (20.3%) | ||
6 | 2863 (51.3%) | 21,748 (42.2%) | ||
Charlson Index | 0 | 2788 (45.4%) | 23,704 (42.3%) | <0.001 |
1 | 1658 (27.0%) | 16,666 (29.7%) | ||
2 | 1693 (27.6%) | 15,730 (28.0%) | ||
Disabling Disease | 0 | 578 (9.4%) | 5696 (10.1%) | 0.014 |
1 | 1432 (23.3%) | 13,666 (24.3%) | ||
2 | 1771 (28.8%) | 16,269 (28.9%) | ||
3 | 1390 (22.6%) | 12,359 (22.0%) | ||
4 | 979 (15.9%) | 8229 (14.6%) | ||
Sepsis Group | 1 | 4757 (77.3%) | 42,985 (76.5%) | 0.073 |
2 | 1171 (19.0%) | 11,347 (20.2%) | ||
3 | 222 (3.6%) | 1887 (3.4%) | ||
MDC Respiratory | 4796 (78.0%) | 40,554 (72.1%) | <0.001 | |
1354 (22.0%) | 15,665 (27.9%) | |||
MDC Cardiovascular | 0 | 4906 (79.8%) | 46,879 (83.4%) | <0.001 |
1 | 1244 (20.2%) | 9340 (16.6%) | ||
MDC Neurology | 0 | 5015 (81.5%) | 47,296 (84.1%) | <0.001 |
1 | 1135 (18.5%) | 8923 (15.9%) |
Predictor | IRR | SE | z | p > z | 95% CI | |
---|---|---|---|---|---|---|
Single Parent | ||||||
Q2 | 1.18 | 0.02 | 10.4 | 0.000 | 1.14 | 1.21 |
Q3 | 1.45 | 0.02 | 25.6 | 0.000 | 1.41 | 1.49 |
Q4 | 1.33 | 0.02 | 21.0 | 0.000 | 1.30 | 1.37 |
Q5 | 1.69 | 0.02 | 30.5 | 0.000 | 1.63 | 1.75 |
Education <15 years | ||||||
Q2 | 1.46 | 0.03 | 16.9 | 0.000 | 1.40 | 1.53 |
Q3 | 1.22 | 0.03 | 9.1 | 0.000 | 1.17 | 1.27 |
Q4 | 1.07 | 0.02 | 3.3 | 0.001 | 1.03 | 1.12 |
Q5 | 1.19 | 0.02 | 8.8 | 0.000 | 1.15 | 1.24 |
Dependency Ratio | ||||||
Q2 | 1.11 | 0.02 | 6.5 | 0.000 | 1.07 | 1.14 |
Q3 | 1.97 | 0.03 | 44.4 | 0.000 | 1.91 | 2.03 |
Q4 | 1.56 | 0.02 | 30.6 | 0.000 | 1.51 | 1.60 |
Q5 | 1.82 | 0.02 | 36.8 | 0.000 | 1.76 | 1.88 |
Deprivation Index | ||||||
Q3 | 1.54 | 0.04 | 17.8 | 0.000 | 1.47 | 1.62 |
Q4 | 2.13 | 0.05 | 33.0 | 0.000 | 2.04 | 2.23 |
Q5 | 2.94 | 0.05 | 62.2 | 0.000 | 2.84 | 3.04 |
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Cournane, S.; Conway, R.; Byrne, D.; O’Riordan, D.; Coveney, S.; Silke, B. Social Factors Determine the Emergency Medical Admission Workload. J. Clin. Med. 2017, 6, 59. https://doi.org/10.3390/jcm6060059
Cournane S, Conway R, Byrne D, O’Riordan D, Coveney S, Silke B. Social Factors Determine the Emergency Medical Admission Workload. Journal of Clinical Medicine. 2017; 6(6):59. https://doi.org/10.3390/jcm6060059
Chicago/Turabian StyleCournane, Seán, Richard Conway, Declan Byrne, Deirdre O’Riordan, Seamus Coveney, and Bernard Silke. 2017. "Social Factors Determine the Emergency Medical Admission Workload" Journal of Clinical Medicine 6, no. 6: 59. https://doi.org/10.3390/jcm6060059
APA StyleCournane, S., Conway, R., Byrne, D., O’Riordan, D., Coveney, S., & Silke, B. (2017). Social Factors Determine the Emergency Medical Admission Workload. Journal of Clinical Medicine, 6(6), 59. https://doi.org/10.3390/jcm6060059