Applying a cost-effectiveness threshold to delay-related harm in emergency admissions: a novel approach

We approach emergency department delay-related harm as though it were a distinct condition and explore use of an explicit cost-effectiveness threshold as a guide to management. Based on the reported association of delayed emergency admission with short-term mortality, to prevent loss of one quality-adjusted life year per patient harmed in Ireland, annual resources equivalent to 70 additional bed years, or infrastructure funding for 90 new beds, could be considered cost-effective. The additional commitment represents under 1% of annual public acute hospital sector expenditure in Ireland, an OECD member country.