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PB7 Does more mean less? The impact of increased consultant numbers on ED admission rates
  1. D Hewitt,
  2. P Jennings,
  3. M Clements1
  1. 1Airedale General Hospital

Abstract

Objectives and Background The College of Emergency Medicine has recommended an expansion of the consultant workforce; this is intended to improve patient care, patient safety, cost efficiency and further the development of emergency care.1 The aim of this study was to see if admission rates have reduced in the Airedale General Hospital Emergency Department since the addition of 2 consultants, a total of 6, in April 2011.

Method Weekly data was collected from Airedale General Hospital Emergency Department between January 2010–July 2011, consisting of number of admissions, whether they were classified as major or minor injury and total number of attendances. Weekly admission rates for April–July 2010 and December-March 2011 were compared separately with April–July 2011 using an unpaired T-Test.

Results There was a statistical difference between admissions rates for December–March 11 and April–July 11 (p≤0.0001) but not between April–July 10 and April–July 11 (p=0.0657). For total attendance and percentage of major admissions respectively April–July 10 had 18 842 and 41.1%, December–March 11 had 17 353 and 41.6% and April–Jul 11 had 18 937 and 45.9%.

Conclusions April–July 11 had lower mean admission rates than both April–July 10 and December–March 11, although this was only statistically significant for December–March 11. April–July 11 also had a greater number of attendances and a higher percentage of high tariff patients. These two factors could explain why the admission rate was not statistically significant when compared to April–July 10. However, it is unknown whether the HRG tariffs correlate well with clinical complexity or need for admission. Limitations of this study are the relatively short time periods analysed, changes to practice, such as new clinical guidelines, have not been taken into account, and these results alone cannot prove causality between decreased admission rates and consultant numbers.

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