Exploring emergency department 4-hour target performance and cancelled elective operations: a regression analysis of routinely collected and openly reported NHS trust data.

Objective: To quantify the effect of intra-hospital patient flow on Emergency Department (ED) performance targets and indicate if the expectations set by the NHS England five year forward review are realistic in returning emergency services to previous performance levels. Design: Linear regression analysis of routinely reported trust activity and performance data using a series of cross-sectional studies. Setting: NHS trusts in England submitting routine nationally reported measures to NHS England. Participants: 142 acute non-specialist trusts operating in England between 2012 and 2016. Main outcome measures: The primary outcome measures were: proportion of four-hour waiting time breaches and cancelled elective operations. Methods: Univariate and multivariate linear regression models were used to show relationships between the outcome measures, and various measures of trust activity including: empty day-beds, empty night-beds, day-to-night bed ratio, ED conversion ratio and delayed tran...研究目标：量化医院内部患者流动对急诊科（Emergency Department，ED）绩效指标的影响，并评估英国国民保健署英格兰分部（NHS England）《五年远期规划》所设定的、将急诊服务恢复至此前绩效水平的目标是否切实可行。 研究设计：采用一系列横断面研究，对常规上报的医疗机构运营与绩效数据开展线性回归分析。 研究场景：英格兰地区向英国国民保健署英格兰分部（NHS England）上报常规全国性绩效指标的国民保健署信托医疗机构。 研究对象：2012至2016年间在英格兰地区运营的142家急性非专科国民保健署信托医疗机构。 主要结局指标：首要结局指标为四小时候诊超时率与择期手术取消率。 研究方法：采用单变量与多变量线性回归模型，分析结局指标与各类医疗机构运营指标间的关联，所纳入的运营指标包括日间空床位、夜间空床位、日间-夜间床位比、急诊科转换率以及延迟转运（delayed tran...）。