Variation in demand for accident and emergency departments in England from 1974 to 1985.

Milner, P C; Nicholl, Jon; Williams, Brian

doi:10.1136/jech.42.3.274

Cited by 32 publications

(10 citation statements)

References 15 publications

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“…These data also show increased numbers of attendances over the nine week period, consistent with the nationally recognised increasing numbers, 8 although changes in this short study period may be for other reasons such as seasonal variation.…”

Section: Discussionsupporting

confidence: 80%

A major sporting event does not necessarily mean an increased workload for accident and emergency departments. Euro96 Group of Accident and Emergency Departments.

Cooke¹,

Allan²,

Wilson³

1999

Br J Sports Med

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Aim-To determine whether there were any changes in attendance at accident and emergency departments that could be related to international football matches (Euro96 tournament). Method-Fourteen accident and emergency departments (seven adjacent to and seven distant from a Euro96 venue) provided their daily attendance figures for a nine week period: three weeks before, during, and after the tournament. The relation between daily attendance rates and Euro96 football matches was assessed using a generalised linear model and analysis of variance. The model took into account underlying trends in attendance rates including day of the week. Results-The 14 hospitals contributed 172 366 attendances (mean number of daily attendances 195). No association wasshown between the number of attendances at accident and emergency departments and the day of the football match, whether the departments were near to or distant from stadia or the occurrence of a home nation match. The only observed independent predictors of variation were day of the week and week of the year. Attendance rates were significantly higher on Sunday and/or Monday; Monday was about 9% busier than the daily average. Increasing attendance was observed over time for 86% of the hospitals. Conclusion-Large sports tournaments do not increase the number of patients attending accident and emergency departments. Special measures are not required for major sporting events over and above the capacity of an accident and emergency department to increase its throughput on other days. (Br J Sports Med 1999;33:333-335)

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Section: Discussionsupporting

confidence: 80%

A major sporting event does not necessarily mean an increased workload for accident and emergency departments. Euro96 Group of Accident and Emergency Departments.

Cooke¹,

Allan²,

Wilson³

1999

Br J Sports Med

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“…It has been hard to quantify the effect of deprivation on use of accident and emergency departments because they do not serve defined populations 7 8 9. It has been suggested that there is less out of hours activity in general practices in inner cities than would otherwise be expected because of the proximity of accident and emergency departments 10 11.…”

Section: Introductionmentioning

confidence: 99%

Relation of out of hours activity by general practice and accident and emergency services with deprivation in Nottingham: longitudinal survey

Carlisle

Groom

Avery

et al. 1998

BMJ

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Objectives: To investigate the relation between out of hours activity of general practice and accident and emergency services with deprivation and distance from accident and emergency department. Design: Six month longitudinal study. Setting: Six general practices and the sole accident and emergency department in Nottingham. Subjects: 4745 out of hours contacts generated by 45 182 patients from 23 electoral wards registered with six practices. Main outcome measures: Rates of out of hours contacts for general practice and accident and emergency services calculated by electoral ward; Jarman and Townsend deprivation scores and distance from accident and emergency department of electoral wards. Results: Distances of wards from accident and emergency department ranged from 0.8 to 9 km, and Jarman deprivation scores ranged from − 23.4 to 51.8. Out of hours contacts varied by ward from 110 to 350 events/1000 patients/year, and 58% of this variation was explained by the Jarman score. General practice and accident and emergency rates were positively correlated (Pearson coefficient 0.50, P = 0.015). Proximity to accident and emergency department was not significantly associated with increased activity when deprivation was included in regression analysis. One practice had substantially higher out of hours activity (B coefficient 124 (95% confidence interval 67 to 181)) even when deprivation was included in regression analysis. Conclusions: A disproportionate amount of out of hours workload fell on deprived inner city practices. High general practice and high accident and emergency activity occurred in the same areas rather than one service substituting for the other.

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“…'O," There was also evidence that accident and emergency departments were providing nearly half of first patient contacts in some urban areas. '2 Night calls in general practice also appeared to have increased during the 1980s, with a rate of 10 Modernisation and its problems This modernisation created a range of problems for GPs, which were to become issues of public concern and government attention during the decade. The policy agenda for general practice in the 1980s included the problems of primary care in the inner cities and other deprived areas, prescribing policies and practices,'5 the use of microcomputers, regulation of commercial deputising services, and GP referrals to specialists.…”

mentioning

confidence: 99%

The modernisation of general practice in the UK: 1980 to 1995 and beyond. Part I

Iliffe¹

1996

Postgraduate Medical Journal

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The UK is unusual in providing universal free healthcare in which access to specialists is largely controlled by general practitioners with 24-hour responsibility, throughout the year, for a defined list of patients of all ages. It is generally considered that this gatekeeper function has contributed to the relatively low cost of the National Health Service, but major changes in the organisation and clinical role of general practitioners have occurred, culminating in a new contract that aims to re-orientate general practice towards health promotion, disease prevention and the management of chronic disease. The implications of these changes are discussed.

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Variation in demand for accident and emergency departments in England from 1974 to 1985.

Cited by 32 publications

References 15 publications

A major sporting event does not necessarily mean an increased workload for accident and emergency departments. Euro96 Group of Accident and Emergency Departments.

A major sporting event does not necessarily mean an increased workload for accident and emergency departments. Euro96 Group of Accident and Emergency Departments.

Relation of out of hours activity by general practice and accident and emergency services with deprivation in Nottingham: longitudinal survey

The modernisation of general practice in the UK: 1980 to 1995 and beyond. Part I

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