Aims and Objectives In recent years there has been a large increase in demand for emergency care across the country, particularly during winter. This study utilised 12 months’ of routinely collected data from Emergency Departments (EDs) and acute Admitted Patient Care Episodes (APCs) to understand trends in demand for emergency care. Specifically, we examined factors associated with seasonal variation in overall demand and avoidable usage of emergency care.

Method and Design Data was obtained from 20 EDs and associated acute hospitals from 1/11/20201-31/10/2022. Main outcomes included ED waiting times, total time in ED, the number of treatments, investigations or procedures received, and whether the attendance or admission was considered ‘avoidable’.

Using a novel ‘federated’ analysis exploiting local relationships with data providers, regional researchers analysed local data and provided summary statistics and analysis results to the lead site. Aggregation of summary results established a picture of seasonal demand across the country, and an understanding of local variation in seasonal trends.

Results and Conclusion After controlling for key variables, results indicated that ED outcomes showed more seasonal and regional variation than APC outcomes (figure 1). However, there were no clear systematic effects of winter across all sites for any outcome.

Findings suggest that seasonal pressures on emergency care are complex and not due simply to increases in treatments or procedures, or to increased avoidable usage. Although seasonal virus diagnoses were controlled for, absolute numbers of these cases were too small to have fully accounted for seasonal pressure. Hospitals may already be accounting well for increased seasonal demand, moderating any observed effect of season. Ongoing work aims to establish more complex combinations of factors e.g., trends in demographics which may help to clarify findings.

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Abstract 2315 Figure 1

Example aggregated outcomes from ECDS and APC analyses. Estimates show the adjusted effect of winter (Oct-March)