Multimorbidity clustering of the emergency department patient flow: Impact analysis of new unscheduled care clinics

Author:

Wartelle AdrienORCID,Mourad-Chehade Farah,Yalaoui Farouk,Questiaux Hélène,Monneret Thomas,Soliveau Ghislain,Chrusciel Jan,Duclos Antoine,Laplanche David,Sanchez StéphaneORCID

Abstract

Background In France, the number of emergency department (ED) admissions doubled between 1996 and 2016. To cope with the resulting crowding situation, redirecting patients to new healthcare services was considered a viable solution which would spread demand more evenly across available healthcare delivery points and render care more efficient. The objective of this study was to analyze the impact of opening new on-demand care services based on variations in patient flow at a large hospital emergency department. Methods We performed a before-and-after study investigating the use of unscheduled care services in the Aube region in eastern France, that focused on ED attendance at Troyes Hospital. A hierarchical clustering based on co-occurrence of diagnoses was applied which divided the population into different multimorbidity profiles. Temporal trends of the resultant clusters were also studied empirically and using regression models. A multivariate logistic regression model was constructed to adjust the periodic effect for appropriate confounders and therefore confirm its presence. Results In total, 120,722 visits to the ED were recorded over a 24-month period (2018–2019) and 16 clusters were identified, accounting for 94.76% of all visits. There was a decrease of 56.77 visits per week in seven specific clusters and an increase of use of unscheduled health care services by 328.12 visits per week. Conclusions Using an innovative and reliable methodology to evaluate changes in patient flow through the ED, these findings may help inform public health policy experts on the implementation of unscheduled care services to ease pressure on hospital EDs.

Funder

Health Regional Agency

Publisher

Public Library of Science (PLoS)

Subject

Multidisciplinary

Reference53 articles.

1. DREES. France. Ministère du travail, de l’emploi et de la santé. Direction de la recherche, des études, de l’évaluation et des statistiques. Le panorama des établissements de santé: édition 2017. 2017. Available: https://drees.solidarites-sante.gouv.fr/IMG/pdf/28-2.pdf

2. Emergency department crowding: A systematic review of causes, consequences and solutions;C Morley;PLoS One,2018

3. The Effect of Emergency Department Expansion on Emergency Department Overcrowding;JH Han;Acad Emerg Med,2007

4. Do Adult Medicaid Enrollees Prefer Going to Their Primary Care Provider’s Clinic Rather Than Emergency Department (ED) for Low Acuity Conditions?;R Capp;Med Care,2015

5. Factors associated with inappropriate use of emergency departments: findings from a cross-sectional national study in France;D Naouri;BMJ Qual & Saf,2019

Cited by 4 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3