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There are considerable misconceptions about emergency admissions. Many claim them to be predictable! Studies show that the link between the weather and environment (pollution, viral & other infections) creates the opportunity for emergency admissions to show highly erratic trends over time.
Indeed the financial risk associated with emergency admissions is very high and is up to 3-times higher than due to chance variation alone. There are considerable implications to the longer-term bed requirements of hospitals, to commissioning activity and the issue of whether emergency admissions should be part of Practice Based Commissioning (PBC).
HCAF estimate that both the 2009/10 and 2010/11 short stay tarrif in England, created the situation where acute Trusts were making a profit margin of somewhere between £400 to £1,300 per zero day stay 'emergency admission' made via an assessment unit. This anomaly is largely due to the fact that while all HRG can have a zero day stay only 419 HRG have a short stay tariff. In the remaining 656 HRG the purchaser pays full tariff for a zero day stay while the average cost for an assessment unit 'admission' is only £340, i.e. close to the upper end of an outpatient attendance.
Emergency Admissions Series
British Journal of Healthcare Management (BJHCM)
Jones R (1996) Estimation of annual activity and the use of activity multipliers.
Health Informatics 2, 71-77
Jones R (1997) Emergency admissions: Admissions of difficulty.
Health Service Journal 107(5546), 28-31 Read Me
Jones R (2009) Trends in emergency admissions. BJHCM 15(4), 188-196 Read Me
Jones R (2009) Cycles in emergency admissions. BJHCM 15(5), 239-246 Read Me
Jones R (2009) Emergency admissions and hospital beds. BJHCM 15(6), 289-296 Read Me
Jones R (2009) Emergency admissions and financial risk. BJHCM 15(7), 344-350 Read Me
Jones R (2010) Cyclic factors behind NHS deficits and surpluses BJHCM 16(1), 48-50
Jones R (2010) Emergency preparedness. BJHCM 16(2), 94-95 Read Me
Jones R (2010) Unexpected, periodic, increase in medical inpatient care: Man-made or new disease? Medical Hypotheses 74(6): 978-983 Read Me
Jones R (2010) Can time-related patterns in diagnosis for hospital admissions help identify common root causes for disease expression? Medical Hypotheses 75(2): 148-154 Read Me
Jones R (2010) The case for recurring outbreaks of a new type of infectious disease across all parts of the United Kingdom. Medical Hypotheses 75: in press http://dx.doi.org/10.1016/j.mehy.2010.04.023 or Read Me
Jones R (2010) The nature of health care costs and financial risk in commissioning. BJHCM 16: (in press)
Jones R (2010) Costing emergency assessment unit admissions. BJHCM 16: (in press)
Jones R (2010) Costing accident & emergency attendences. BJHCM 16: (in press)
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Emergency Admissions