Changes in the way that illness is dealt with in the community are putting more pressure on emergency care services, according to a study published today. It finds that the changing profile of patients needing emergency care medicine across the UK has led to longer waiting times for those who are seriously ill and who need urgent treatment.The findings, published in “Emergency Medicine Journal” are based on ten years of data collected from three emergency departments, including one minor injuries unit, in Sheffield. The information records the time taken for every episode of care, from the moment each patient booked in until they were discharged from the emergency medicine department. The data covers four months from April to July in every year from 1993 to 2003.
The study divides patients into “minors” and “majors”, the first being those people who arrived under their own steam, and were subsequently discharged and the more serious category covering those who arrived at the units by emergency ambulance and were subsequently admitted to hospital.
Over the decade under review, the number of emergency care attendances increased by 969, a little over one per cent, year on year, with the proportion of people being admitted to hospital going up by seven per cent. The number of patients aged from 16 to 29 fell by ten per cent while the numbers of patients aged over 80 rose from just over six per cent of the total to more than ten per cent. The proportion of patients arriving by ambulance also went up from around 23 per cent to a peak of to 32 per cent in 2002. Over the ten years the proportion of minor emergencies fell by around ten per cent.
The findings show that average waiting times doubled, and average treatment times also lengthened, especially for the major cases, which almost quadrupled from 55 minutes in 1993 to one hour 45 minutes in 2003, despite increases in staffing levels. Overall, the percentage of patients seeing a healthcare professional within an hour of their arrival fell by about a fifth over the decade.
The study’s authors say the results suggest an additional 9,000 patients a year are being admitted to hospital in Sheffield, at a time when the number of beds has fallen and they suggest that changes in the way illness is dealt with in the community are putting undue pressure on emergency care services.