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Identification of Medical Admissions suitable for Same Day Emergency Care (SDEC)

Population Size

141,921

People

Years

2019 - 2020

Associated BioSamples

None/not available

Geographic coverage

United Kingdom

England

Lead time

Not applicable

Summary

Acute patient data (2004 onwards) for patients with unplanned medical admission who receive Same Day Emergency Care. Granular condition, presenting complaint, acuity, ethnicity, multi-morbidity. Serial physiology, blood biomarkers, treatments.

Documentation

Emergency hospital admissions in the UK have been rising steadily. Medical emergencies account for the largest proportion of unplanned admissions. Same Day Emergency Care (SDEC) is one of many ways the NHS are working to provide the right care, in the right place and at the right time. The national SDEC model builds on the previous work undertaken in ambulatory emergency care (AEC) services across the NHS, which was aimed at providing a consistent approach to patient pathways.

A proportion of medical admissions are suitable for SDEC, where they are assessed and treated, but do not require overnight admission to an inpatient bed. This is beneficial for patients, as hospital admission and its associated risks can be avoided. As inpatient admissions increase, it is also important to consider alternative methods of care to reduce pressure on inpatient services. SDEC is highlighted in the NHS Long Term Plan, recommending a third of patients in acute services should receive SDEC.

The number of medical patients receiving SDEC varies between centres. This may relate to local patient populations, but also local availability of services. SDEC is often delivered through Ambulatory Emergency Care, as well as the Acute Medical Unit, and multiple additional services can aid delivery, including hospital at home services, and early outpatient review in specialist clinics. These services vary between hospitals.

PIONEER geography The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix.

EHR. UHB is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & an expanded 250 ITU bed capacity during COVID. UHB runs a fully electronic healthcare record (EHR) (PICS Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”.

Scope: All patients admitted with unplanned medical admissions who receive Same Day Emergency Care from 2004 onwards. The dataset includes highly granular patient demographics & co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to acute care process (timings, staff grades, specialty review, wards), presenting complaint, acuity, all physiology readings (pulse, blood pressure, respiratory rate, oxygen saturations), all blood results, imaging reports, all prescribed & administered treatments (fluids, blood products, procedures), all outcomes.

Available supplementary data: Matched controls ambulance, synthetic data.

Available supplementary support: Analytics, Model build, validation & refinement A.I. Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.

Dataset type
Health and disease
Dataset sub-type
Not applicable
Dataset population size
141,921

Keywords

acute care, Same Day Emergency Care, SDEC, Ambulatory Emergency Care, care pathways, admissions, avoid admissions, Acute Medicine, Acute Medical Unit, multi-morbidity, ICD-10, SNOMED-CT, Ethnicity, adults, Children, acuity, Medications, physiology, Blood tests, Laboratory results, Hospital Ward, Medical imaging, Outcomes, Place of discharge, Mortality

Observations

Observed Node
Disambiguating Description
Measured Value
Measured Property
Observation Date

Persons

141,921 same day emergency spells that are completed in 48 hours or less from 2019-04-01 to 2020-09-30

141921

Count

16 May 2021

Provenance

Purpose of dataset collection
Care
Source of data extraction
EPR
Collection source setting
Secondary care - Accident and Emergency, Secondary care - In-patients, Secondary care - Outpatients
Patient pathway description
Data is representative of the multi-ethnicity population within the West Midlands (42% non white). Data includes all patients admitted during this timeframe, with National data Opt Outs applied, and therefore is representative of admissions to secondary care. Data focuses on in-patient stay in hospital during the acute episode, but can be supplemented on request to include previous and subsequent hospital contacts (including outpatient appointments) and ambulance, 111, 999 data.
Image contrast
Not stated
Biological sample availability
None/not available

Structural Metadata

Details

Publishing frequency
Quarterly
Version
1.0.0
Modified

08/10/2024

Distribution release date

16/05/2021

Citation Requirements
This publication uses data from PIONEER, an ethically approved database and analytical environment (East Midlands Derby Research Ethics 20/EM/0158)

Coverage

Start date

31/03/2019

End date

29/09/2020

Time lag
Other
Geographic coverage
United Kingdom, England, West Midlands
Minimum age range
16
Maximum age range
110
Follow-up
Other

Accessibility

Language
en
Alignment with standardised data models
LOCAL
Controlled vocabulary
SNOMED CT, ICD10
Format
SQL

Data Access Request

Dataset pipeline status
Available
Time to dataset access
Not applicable
Access request cost
www.pioneerdatahub.co.uk/data/data-services-costs/
Access method category
TRE/SDE
Access service description

Trusted Research Environments (TRE) are built using Microsoft Azure services and hosted in the UK to provide research teams a safe, secure and agile environment which allows users to quickly analyse, interpret and form an enriched view of primary care information through a range of integrated datasets.

Health data collated from multiple sources is ingested into a secure data lake which will then allow subsets of data to be made available to research teams on approval of a data request. Once approved a customer specific TRE is made available with a standard set of leading analytical tools from Microsoft including Azure Databricks, Azure Machine Learning, Azure SQL and Azure Synapse (for large-scale data warehouses). Specific tools can be provided at an additional cost over the standard platform data access charge and the PIONEER team will work with you to determine your exact needs.

Access to the TRE is managed using the latest virtual desktop technology to provide a safe and secure end-user experience. By utilising leading edge design PIONEER are able to create TREs rapidly to enable us to service any customer requirement.

Jurisdiction
GB-ENG
Data use limitation
General research use
Data use requirements
Project-specific restrictions
Data Controller
University Hospitals Birmingham NHS Foundation Trust

Dataset Types: Health and disease


Collection Sources: No collection sources listed