scholarly journals Outcomes for Patients Who Contact the Emergency Ambulance Service and Are Not Transported to the Emergency Department: A Data Linkage Study

2019 ◽  
Vol 23 (4) ◽  
pp. 566-577 ◽  
Author(s):  
Joanne Coster ◽  
Alicia O'Cathain ◽  
Richard Jacques ◽  
Annabel Crum ◽  
A. Niroshan Siriwardena ◽  
...  
Keyword(s):  
Emergency Department ◽  
Data Linkage ◽  
Linkage Study ◽  
Ambulance Service ◽  
Emergency Ambulance

scholarly journals Using deterministic record linkage to link ambulance and emergency department data: is it possible without patient identifiers?

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Sophie Jane Clark ◽  
Mary Halter ◽  
Alison Porter ◽  
Holly Christina Smith ◽  
Martin Brand ◽  
...  
Keyword(s):  
Emergency Department ◽  
Record Linkage ◽  
Emergency Departments ◽  
Data Linkage ◽  
Care Delivery ◽  
Ambulance Service ◽  
Emergency Department Data ◽  
Match Rate ◽  
Emergency Ambulance ◽  
The Uk

IntroductionRoutine linkage of emergency ambulance records with those from the emergency department is uncommon in the UK. Our study, known as the Pre-Hospital Emergency Department Data Linking Project (PHED Data), aimed to link records of all patients conveyed by a single emergency ambulance service to thirteen emergency departments in the UK from 2012-2016. Objectives We aimed to examine the feasibility and resource requirements of collecting de-identified emergency department patient record data and, using a deterministic matching algorithm, linking it to ambulance service data. Methods We used a learning log to record contacts and activities undertaken by the research team to achieve data linkage. We also conducted semi-structured interviews with information management/governance staff involved in the process. Results We found that five steps were required for successful data linkage for each hospital trust. The total time taken to achieve linkage was a mean of 65 weeks. A total of 958,057 emergency department records were obtained and, of these, 81% were linked to a corresponding ambulance record. The match rate varied between hospital trusts (50%-94%). Staff expressed strong enthusiasm for data linkage. Barriers to successful linkage were mainly due to inconsistencies between and within acute trusts in the recording of two ambulance event identifiers (CAD and call sign). Further data cleaning was required on emergency department fields before full analysis could be conducted. Ensuring the data was not re-identifiable limited validation of the matching method. Conclusion We conclude that deterministic record linkage based on the combination of two event identifiers (CAD and call sign) is possible. There is an appetite for data linkage in healthcare organisations but it is a slow process. Developments in standardising the recording of emergency department data are likely to improve the quality of the resultant linked dataset. This would further increase its value for providing evidence to support improvements in health care delivery. Highlights Ambulance records are rarely linked to other datasets; this study looks at the feasibility and resource requirement to use deterministic matching to link ambulance and emergency department data for patients conveyed by ambulance to the emergency department. It is possible to link these data, with an average match rate of 81% across 13 emergency departments and one large ambulance trust. All trusts approached provided match-able data and there was an appetite for data linkage; however, it was a long process taking an average of 65 weeks. We conclude that deterministic matching using no patient identifiers can be used in this setting.

scholarly journals Helicopter Emergency Ambulance Service (HEAS) Transfer: An Analysis of Trauma Patient Case-Mix, Injury Severity and Outcome

2007 ◽  
Vol 89 (5) ◽  
pp. 513-516 ◽  
Author(s):  
JTK Melton ◽  
S Jain ◽  
B Kendrick ◽  
SD Deo
Keyword(s):  
Emergency Department ◽  
Injury Severity ◽  
Ambulance Service ◽  
Case Mix ◽  
Trauma Patients ◽  
Patient Case ◽  
Average Hospital ◽  
Acute Setting ◽  
Time Period ◽  
Emergency Ambulance

INTRODUCTION A retrospective review of all patients transferred by helicopter ambulance to the Great Western Hospital over a 20-month period between January 2003 and September 2004 was undertaken to establish the case-mix of patients (trauma and non-trauma) transferred and the outcome. PATIENTS AND METHODS Details of all Helicopter Emergency Ambulance Service (HEAS) transfers to this unit in the study time period were obtained from the three HEAS providers in the area and case notes were reviewed. RESULTS There were 156 trauma patients transferred (total 193) in the study period with 111 cases identified for analysis with a mean age of 33 years (range, 1–92 years). Average Injury Severity Score on admission was 12 (range, 1–36). Forty-five patients were discharged home from the emergency department, 24 cases had operation, 10 patients required ICU care and 2 were pronounced dead in the emergency department. Average hospital stay following HEAS transfer was 2.97 days (range, 0–18 days). DISCUSSION Helicopter ambulance transfer in the acute setting is of debated value. Triage criteria are at fault if as many as 41% of patients transferred are being discharged home from casualty having incurred the financial cost of helicopter transfer. We suggest that the triage criteria for helicopter emergency transfer should be reviewed.

Patients with Diabetes Presenting with Hyperglycemia to a Tertiary Care Emergency Department: A Data Linkage Study

2018 ◽  
Vol 42 (5) ◽  
pp. S30
Author(s):  
Zarina Markova ◽  
Selina L. Liu ◽  
Tamara Spaic ◽  
Melanie P. Columbus ◽  
Kristine Van Aarsen ◽  
...  
Keyword(s):  
Emergency Department ◽  
Data Linkage ◽  
Tertiary Care ◽  
Linkage Study ◽  
Patients With Diabetes

scholarly journals Use of the Emergency Ambulance Service to an Inner City Accident and Emergency Department – a Comparison of General Practitioner and ‘999’ Calls

1991 ◽  
Vol 84 (12) ◽  
pp. 726-727 ◽  
Author(s):  
A G Pennycook ◽  
R M Makower ◽  
W G Morrison
Keyword(s):  
Emergency Department ◽  
Inner City ◽  
Hospital Setting ◽  
Ambulance Service ◽  
Inappropriate Use ◽  
Accident And Emergency ◽  
Emergency Ambulance ◽  
Accident And Emergency Department ◽  
A Prospective Study ◽  
Effective Use

Over a 2-week period a prospective study was undertaken of patients brought to an inner city accident and emergency department by the emergency ambulance service. Criteria for assessing the appropriateness of use of the emergency ambulance service are not well defined and at worst entirely subjective. The author's finding that, of patients attending after a ‘999’ call, 49.8% were discharged with no follow-up suggests that many of these journeys represented inappropriate use of the emergency ambulance service. Close liaison between senior medical staff and the emergency ambulance service may allow more appropriate and effective use of the service, improving patient care in the pre-hospital setting.

scholarly journals Emergency department presentation and readmission after index psychiatric admission: a data linkage study

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018613 ◽  
Author(s):  
Xue Li ◽  
Preeyaporn Srasuebkul ◽  
Simone Reppermund ◽  
Julian Trollor
Keyword(s):  
Emergency Department ◽  
Intellectual Disability ◽  
Service Use ◽  
Data Linkage ◽  
Linkage Study ◽  
Index Admission ◽  
Psychiatric Admission ◽  
Psychiatric Readmission ◽  
Factors Associated ◽  
Drug And Alcohol

ObjectiveTo use linked administrative datasets to assess factors associated with emergency department (ED) presentation and psychiatric readmission in three distinctive time intervals after the index psychiatric admission.DesignA retrospective data-linkage study.SettingCohort study using four linked government minimum datasets including acute hospital care from July 2005 to June 2012 in New South Wales, Australia.ParticipantsPeople who were alive and aged ≥18 years on 1 July 2005 and who had their index admission to a psychiatric ward from 1 July 2007 to 30 June 2010.Outcome measuresORs of factors associated with psychiatric admission and ED presentation were calculated for three intervals: 0–1 month, 2–5 months and 6–24 months after index separation.ResultsIndex admission was identified in 35 056 individuals (51% -males) with a median age of 42 years. A total of 12 826 (37%) individuals had at least one ED presentation in the 24 months after index admission. Of those, 3608 (28%) presented within 0–1 month, 6350 (50%) within 2–5 months and 10 294 (80%) within 6–24 months after index admission. A total of 14 153 (40%) individuals had at least one psychiatric readmission in the first 24 months. Of those, 6808 (48%) were admitted within 0–1 month, 6433 (45%) within 2–5 months and 7649 (54%) within 6–24 months after index admission. Principal diagnoses and length of stay at index admission, sociodemographic factors, Charlson Comorbidity Index score, drug and alcohol comorbidity, intellectual disability and other inpatient service use were significantly associated with ED presentations and psychiatric readmissions, and these relationships varied somewhat over the intervals studied.ConclusionSocial determinants of service use, drug and alcohol intervention, addressing needs of individuals with intellectual disability and recovery-oriented whole-person approaches at index admission are key areas for investment to improve trajectories after index admission.

scholarly journals Comparing emergency department presentations among children with cerebral palsy with general childhood presentations: a data linkage study

2017 ◽  
Vol 59 (11) ◽  
pp. 1188-1195 ◽  
Author(s):  
Elaine Meehan ◽  
Katrina Williams ◽  
Susan M Reid ◽  
Gary L Freed ◽  
Franz E Babl ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cerebral Palsy ◽  
Data Linkage ◽  
Linkage Study ◽  
Children With Cerebral Palsy
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