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Longer hospital stay for A&E patients admitted late

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Old person hospital admissionNew figures show patients admitted from A&E in the fourth hour of attendance had longer hospital stays compared to those admitted within the first three hours (under the care of one consultant following admission).

The Health and Social Care Information Centre (HSCIC) report shows in the 12 months to August 2014 one in six admissions from A&E in the fourth hour stayed for 2-3 days (17% or 228,800) and one in 16 stayed for 4-5 days (6% or 82,100). For those admitted from A&E in the first hour, one in seven stayed for 2-3 days (14% or 21,200) and one in 23 stayed for 4-5 days (4% or 6,440). Half of patients admitted in the first hour were discharged the same day (51% or 74,500) compared to only one in three admitted in the fourth hour (36% or 481,500).

The Provisional Monthly Hospital Episode Statistics (HES) for Admitted Patient Care, Outpatients and Accident and Emergency Data report is presented alongside the monthly provisional Hospital Episode Statistics publication released today and provides new analysis into a patient’s journey after arriving at A&E. The report also shows that for all hospital admissions from A&E in September 2013 to August 2014:

  • There were 18.8 million A&E attendances recorded in HES and more than one fifth resulted in a hospital admission (23% or 4.3 million); this is similar to the same period last year.
  • Over half of admissions from an unplanned A&E attendance occurred in the fourth hour (51% or 1.9 million) of which 44% (850,700) were admitted in the final ten minutes. A further one in five attendances were admitted after the four hour period (21% or 791,300). 
  • For those admissions where a cause code was recorded falls, unexpected complications from surgery and intentional self-poisoning were the main reasons for a hospital admission via A&E (38%, 6% and 9% respectively). 
  • One in five patients (21% or 590,100) were admitted from A&E at least twice within the year and 41,900 (1%) were admitted five or more times. 
  • Men and women aged 80 to 84 years (4% and 5% respectively) accounted for the highest number of admissions. 
  • Rate of admissions was highest in Bromley, Hounslow and Chiltern CCGs (418, 379 and 362 admissions per 1,000 A&E attendances respectively).

HSCIC Chair Kingsley Manning said: “Tracking a patient journey from A&E can be a powerful tool for secondary services and today’s report provides new analysis of this.
The relationship between length of hospital stay and the point at which a patient is admitted from A&E provides valuable insight for all involved in secondary care.”

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