dc.contributor.author |
Jones, Peter |
en |
dc.contributor.author |
Schimanski, Karen |
en |
dc.date.accessioned |
2018-10-02T03:16:10Z |
en |
dc.date.issued |
2010-10 |
en |
dc.identifier.issn |
1742-6731 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/38207 |
en |
dc.description.abstract |
Governments in Australasia are introducing emergency department length of stay (EDLOS) time targets similar to the UK 'four hour rule'. There is debate about whether this rule had beneficial effects on health-care outcomes. We sought to determine what effects the four hour time target for EDLOS had on clinically relevant outcomes in the UK by conducting a systematic search for evidence. Articles were screened by both authors independently and assessed for quality using standard tools. Differences in outcomes measured and how they were measured precluded meta-analysis. There were inconsistencies between target achievement reported by Trusts and that reported in the studies, and empirical evidence that the target might be unattainable. National Health Service spending on ED increased £820,000,000.00 (1998-2007) and emergency admissions rose overall by 35% (2002-2006), but not in all hospitals. Time to see a treating clinician and hospital mortality was unchanged. One hospital demonstrated a small reduction in return rate. The impact of the introduction of an ED time target and the associated massive financial investment has not resulted in a consistent improvement in care with markedly varying effects being reported between hospitals. Countries seeking to emulate the UK experience should proceed with caution. |
en |
dc.format.medium |
Print-Electronic |
en |
dc.language |
eng |
en |
dc.relation.ispartofseries |
Emergency medicine Australasia : EMA |
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dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
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dc.subject |
Humans |
en |
dc.subject |
Treatment Outcome |
en |
dc.subject |
Length of Stay |
en |
dc.subject |
Hospital Mortality |
en |
dc.subject |
Time Factors |
en |
dc.subject |
Health Policy |
en |
dc.subject |
Emergency Service, Hospital |
en |
dc.subject |
Health Services Needs and Demand |
en |
dc.subject |
National Health Programs |
en |
dc.subject |
Waiting Lists |
en |
dc.subject |
Health Services Accessibility |
en |
dc.subject |
Australasia |
en |
dc.title |
The four hour target to reduce Emergency Department 'waiting time': a systematic review of clinical outcomes. |
en |
dc.type |
Journal Article |
en |
dc.identifier.doi |
10.1111/j.1742-6723.2010.01330.x |
en |
pubs.issue |
5 |
en |
pubs.begin-page |
391 |
en |
pubs.volume |
22 |
en |
dc.rights.holder |
Copyright: The author |
en |
pubs.end-page |
398 |
en |
pubs.publication-status |
Published |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
en |
pubs.subtype |
Review |
en |
pubs.subtype |
Journal Article |
en |
pubs.elements-id |
685116 |
en |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
School of Medicine |
en |
pubs.org-id |
Surgery Department |
en |
dc.identifier.eissn |
1742-6723 |
en |
pubs.record-created-at-source-date |
2010-11-02 |
en |
pubs.dimensions-id |
20880296 |
en |