Hospital characteristics affecting potentially avoidable emergency admissions: national ecological study.

Area of Science:

• Healthcare Management
• Public Health
• Health Services Research

Background:

• Effective management of acute health exacerbations by emergency and urgent care services can prevent unnecessary hospital admissions.
• In England, emergency and urgent care encompasses hospitals, ambulance services, and primary/community care providers.

Purpose of the Study:

• To investigate the influence of hospital characteristics on rates of potentially avoidable emergency admissions.
• To identify controllable and uncontrollable factors contributing to variations in these admission rates.

Main Methods:

• Calculated age-sex adjusted admission rates for 14 conditions with high avoidable admission potential across 129 English hospitals (2008-2011).
• Analyzed variations in avoidable admission rates in relation to hospital-specific factors.

Main Results:

• Approximately 22% of all emergency admissions were classified as potentially avoidable, exhibiting threefold variations among hospitals.
• Higher rates of potentially avoidable admissions correlated with increased emergency department attendance, greater numbers of acute beds per capita, and higher emergency department attendance-to-admission conversion rates.

Conclusions:

• Hospital characteristics, particularly acute bed supply and emergency department conversion rates, significantly impact avoidable emergency admission rates.
• Hospital managers can potentially reduce avoidable admissions by strategically managing acute bed capacity and improving patient flow from emergency departments.