Implementing Major Trauma Audit in Ireland

Deasy, Conor; Cronin, Marina; Cahill, Fiona; Geary, Úna; Houlihan, Patricia; Woodford, Maralyn; Lecky, Fiona; Mealy, K.; Crowley, Philip

doi:10.1016/j.injury.2015.07.016

Cited by 15 publications

(31 citation statements)

References 24 publications

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“…• Surveys designed to collect additional data on ED and LIU consultant, non-consultant hospital doctor and nursing staffing levels were posted to all hospitals (Response rate = 33%). Secondary sources were used to supplement the survey data [22, 23]. • Presentations at each public ED and LIU were extracted from the HSE Data Management report [21].…”

Section: Methodsmentioning

confidence: 99%

“…• Presentations at each public ED and LIU were extracted from the HSE Data Management report [21]. Private ED and LIU: Activity, Funding and Staffing• Data on consultant staffing and activity in private EDs were estimated by the HSE, based on contractual agreements with consultants around the split between public and private work.• Data on the number of presentations at private LIUs were used to estimate resources used in private clinics [22]. County of Residence: Utilisation• The patient’s county of residence in relation to each ED and LIU presentation was extracted from the Hospital In-Patient Enquiry Scheme, held by the HPO.Population EstimatesCounty and Regional• All population data were taken from the 2011 Census [13].…”

Section: Methodsmentioning

confidence: 99%

“…• Data on the number of presentations at private LIUs were used to estimate resources used in private clinics [22].…”

Section: Methodsmentioning

confidence: 99%

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Variation in resource allocation in urgent and emergency Care Systems in Ireland

Thomas

Foley

Kane

et al. 2019

BMC Health Serv Res

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Background A key challenge for most systems is how to provide effective access to urgent and emergency care across rural and urban populations. Tensions about the placement and scope of hospital emergency services are longstanding in Irish political life and there has been recent reform to centralise hospital services in some regions. The focus of this paper is a system approach to examine the geographic variation in resourcing and utilisation of such care across GP practices, out-of-hours care, ambulance services, Emergency Departments and Local Injury Units in Ireland. Methods We used a cross-sectional study design to evaluate variation in resource allocation by aggregating geographic funding to various elements of the urgent and emergency care system and assessing patterns in hospital resource utilisation across the population. Expenditure, staffing, access and activity data were gathered from government sources, individual facilities and service providers, health professional bodies, private firms and central statistics. Data on costs and activity in 2014 are collated and presented at both county and regional levels. Analyses focus on resources spent on urgent and emergency care across geographic areas, the role of population concentration in allocation, the relationship between pre-hospital spending and in-hospital spending, and the utilisation of hospital-based emergency care resources by residents of each county. Results An array of funding mechanisms exists, resulting in a fragmented approach to the resourcing of urgent and emergency care. There are large differences in spending per capita at the county-level, ranging from between €50 and €200 per capita; however, these are less pronounced regionally. Distribution of hospital emergency care resources is highly skewed to the North East of the country, and away from the recently reconfigured South and Mid-West regions. Conclusions This analysis advances the traditional approach of evaluating individual services or hospital resourcing. There are notable differences in utilisation of hospital-based emergency care resources at the regional level, indicating that populations within those regions which have been reconfigured have lower utilisation of hospital resources. There is a clear case for more integration in decision-making around funding and consideration of key principles, such as equity, to guide that process.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Variation in resource allocation in urgent and emergency Care Systems in Ireland

Thomas

Foley

Kane

et al. 2019

BMC Health Serv Res

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“…More generally, understanding and dealing effectively with serious injuries will benefit greatly from improved trauma data and analysis. A review of trauma arrangements has been undertaken in Ireland (Deasy et al, 2016) and participation in the Trauma Audit and Research Network (TARN) as well as use of standardised templates like the Utstein template (Ringdal et al, 2008) should all contribute to this aim in the future. The Injuries Board is a relatively new data source and at present contains limited information.…”

Section: Limitationsmentioning

confidence: 99%

Record linkage for road traffic injuries in Ireland using police hospital and injury claims data

Short

Caulfield

2016

Journal of Safety Research

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The study of non-fatal road traffic injuries is growing in importance. Since there are rarely comprehensive injury datasets, it is necessary to combine different sources to obtain better estimates on the extent and nature of the problem. Record linkage is one such technique. In this study, anonymised datasets from three separate sources of injury data in Ireland -hospitals, police and injury claims are linked using probabilistic and deterministic linkage techniques. A method is proposed that creates a 'best' set of linked records for analysis, useful when clerical review of undecided cases is not feasible. The linkage of police and hospital datasets shows results that are not dissimilar to those found in other countries, with significant police understatement especially of cyclist and motorcyclist injuries. The addition of the third dataset identifies a large number of additional injuries and demonstrates the error of using only the two main sources for injury data. The study also underlines the risk in relying on the LincolnPetersen capture-recapture estimator to provide an estimate of the total population concerned. The data show that road traffic injuries are significantly more numerous than either police or hospital sources indicate. It is also argued that no single measure can fully capture the range of impacts that a serious injury entails. Record Linkage for Road Traffic Injuries in Ireland using Record Linkage for Road Traffic Injuries in Ireland using Police Hospital and Injury Claims Data ABSTRACTThe study of non-fatal road traffic injuries is growing in importance. Since there are rarely comprehensive injury datasets, it is necessary to combine different sources to obtain better estimates on the extent and nature of the problem. Record linkage is one such technique. In this study, anonymised datasets from three separate sources of injury data in Ireland -hospitals, police and injury claims are linked using probabilistic and deterministic linkage techniques. A method is proposed that creates a 'best' set of linked records for analysis, useful when clerical review of undecided cases is not feasible. The linkage of police and hospital datasets shows results that are not dissimilar to those found in other countries, with significant police understatement especially of cyclist and motorcyclist injuries. The addition of the third dataset identifies a large number of additional injuries and demonstrates the error of using only the two main sources for injury data. The study also underlines the risk in relying on the Lincoln-Petersen capture-recapture estimator to provide an estimate of the total population concerned. The data show that road traffic injuries are significantly more numerous than either police or hospital sources indicate. It is also argued that no single measure can fully capture the range of impacts that a serious injury entails.

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“…Our neighbours in the Republic of Ireland are strides ahead, not only with their successful HEMS service, but in their active contribution to the Trauma Audit Research Network (TARN). 5 We would contend that systematic audit underpins quality trauma care and quality trauma systems. As the authors of a recent report highlighting potential deficiencies in elements of trauma care in Northern Ireland, 6 we would strongly advise that this basic element of governance is addressed before we press ahead with the introduction of a HEMS service.…”

mentioning

confidence: 99%