BMJ 2000;320:1672 ( 17 June )

Letters

Emergency admissions in Stockport were exaggerated

The first 150 words of the full text of this article appear below.

EDITOR---Morgan et al say that the increase in emergency admissions in Avon from 1989 to 1998 may be an artefact.1 Analyses in the annual public health report for Stockport reached a similar, but not identical, conclusion.2

We found that the increases were exaggerated. Information distortions, interhospital transfers, increasing rates of admission for minor conditions, and changed patterns of flow affecting a particular provider unfairly accounted for almost two thirds of the apparent increase, leaving a true underlying pressure of 2.5% a year. Part of this increase was explained by changed practice---for example, improved management of chest pain---and part was unexplained.

The unexplained increase was entirely among elderly people. A rapid response scheme for acute care at home was put in place jointly by health and social services. For the first six months that the scheme was in place there was no year on year increase in emergency admissions . . . [Full text of this article]
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Relevant Article

The rise in emergency admissions---crisis or artefact? Temporal analysis of health services data
Kieran Morgan, David Prothero, and Stephen Frankel
BMJ 1999 319: 158-159. [Extract] [Full Text] [PDF]

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