Targets for length of stay in emergency departments and for access to elective surgery
Citation: Reddy S, Jones P, Shanthanna H, et al. A Systematic review of the impact of healthcare reforms on access to Emergency Department and Elective Surgery Services: 1994–2014. International Journal of Health Services. 2018 Jan;48(1):81-105.
What is this? The COVID-19 pandemic is placing a strain on healthcare services. Existing research on improving access to emergency departments and elective surgery might provide useful information for policy makers.
In this systematic review, the authors searched for studies that analysed the effects of national-level or provincial-level healthcare reforms on length of stay in emergency departments and access to elective surgery in public or public-private hospitals in Australia, Canada, New Zealand and the UK. They restricted their searches to articles published in English between 1994 and 2014. They included 21 studies, from Australia (5 studies) and the UK (16).
What was found: The introduction of time-based emergency department and elective surgery targets improved emergency department length of stay and elective surgery access.
The introduction of targets resulted in unintended consequences, such as increased pressure on clinicians and, in certain instances, manipulation of performance data.
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