Objectives: To describe changes and characteristics in emergency admissions to a West Midlands National Health Service Trust, 2002–2005, with a focus on short stay emergency admissions.
Methods: A longitudinal descriptive study using retrospective analysis of routine admissions data. Admissions were categorised as short (0/1 day) or long (⩾2 days) and examined separately using a General Linear Model. Factors favouring short stays as opposed to long stays were examined using multivariable logistic regression.
Results: There were 151 478 emergency admissions to the Trust between 1 April 2002 and 31 December 2005, of which 2910 (1.92%) had no discharge date recorded. Adjusted means showed a 7.76% increase in emergency admissions in winter months (October–January) and a 14.50% increase across the study period. Increases were greater in short stay (34.03%) than long stay emergency admissions (8.38%). Odds of short stays in admitted patients increased by 25%. Higher odds of short stays were also associated with younger age, winter month and medical admitting specialty (p<0.001).
Conclusions: Increases in emergency admissions were greater in short stay than long stay cases. Reasons for this may be both appropriate (increased use of clinical protocols and falling average length of stay) and detrimental (pressure to meet 4 h emergency department target, changing primary care provision). Further research is needed before generalising findings to other Trusts.
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Conflicts of interest: None.
Ethical approval was obtained from Solihull Local Research Ethics Committee in December 2005
Contributors: ES developed the project, performed data analysis and wrote the first draft of the paper. MWC had the original idea for the study, helped in design and data analysis and reviewed the paper. CMW assisted with study preparation and reviewed the paper. RLH reviewed the statistical methods used. MWC is the guarantor of the paper.
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