Targets for length of stay in emergency departments and for access to elective surgery

Added June 23, 2020

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.


Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.