Emergency - but no Accident

Abstract

Public concern over long waiting times for admissions motivated this study, whose aim was to explore the factors which contribute to such delays. In collaboration with a major London teaching hospital, a system dynamics model of the interaction of demand pattern, A&E resource deployment, other hospital processes and bed numbers was developed. The analysis indicates that while reductions in bed numbers increase waiting times for emergency admissions to a small extent, their principal effect is to increase sharply the number of cancellations of admissions for elective surgery. This suggests that basing A&E policy solely on any single criterion will succeed in transferring the effects of a resource deficit to a different patient group.