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PM-02-02
ED ATTENDANCE AND PERFORMANCE ACROSS THE UK: WHAT’S THE PROBLEM?

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ED ATTENDANCE AND PERFORMANCE ACROSS THE UK: WHAT’S THE PROBLEM?  PM02-02

INTRODUCTION
Waiting times in emergency departments (EDs) correlate negatively with patient experience and outcomes. The UK introduced the 4h waiting time target, such that a percentage (that varies by country of UK) of patients should wait less than 4h for treatment or discharge, however many hospitals are failing to hit the target with consistency, and performance has fallen. In the media, the number of patients attending ED is attributed to this fall in performance.
Objectives: This abstract examines the number of attendances and the percentage attainment of the 4h target, using publically available data to compare the countries of UK.

METHODS
Aggregate administrative data (monthly for August 2010 –December 2016) for 4h performance and ED attendance figures were downloaded from government websites. We restrict the analysis to “major”, “core”, and “Type 1 EDs”. Descriptive statistics are calculated. Control chart analysis is used to examine for changes in performance.

RESULTS
Descriptive statistics:
•The average monthly ED attendances for UK as a whole is ~1.4million
•90.7%patients waiting less than 4h over the whole period
•Englandhas the biggest population and sees the most attendances
•Scotlandhas the highest average performance across the period at 93.3%
Time series:
•Signals for declining performance were evident in the data set in 2012
•Whilst attendances to ED in UK do increase over time, Pearson’s correlation coefficient between attendance and percentage waiting less than 4h is only weakly negative (r=-0.392)
•The same 4h performance levels are attained at varied attendance number

CONCLUSIONS
The rhetoric that increased attendances result in decreased performance is not representative of the complexity of the situation, and should be correspondingly tempered with other factors, including variations in processes within and between nations.

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