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

Dataset
Version: 1.0.0
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.

Summary

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

Documentation

Description:
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.
Is Part Of:
NOT APPLICABLE

Coverage

Spatial:
United Kingdom, England, West Midlands
Typical Age Range:
16-110
Follow Up:
OTHER
Physical Sample Availability:
NOT AVAILABLE
Pathway:
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.

Provenance

Origin

Purposes:
CARE
Sources:
EPR
Collection Situations:
  • ACCIDENT AND EMERGENCY
  • IN-PATIENTS
  • OUTPATIENTS

Temporal

Accrual Periodicity:
QUARTERLY
Distribution Release Date:
2021-05-17
Start Date:
2019-04-01
End Date:
2020-09-30
Time Lag:
OTHER

Accessibility

Access

Access Service:
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.
Access Request Cost:
www.pioneerdatahub.co.uk/data/data-services-costs/
Delivery Lead Time:
1-2 MONTHS
Jurisdictions:
GB-ENG
Data Controller:
University Hospitals Birmingham NHS Foundation Trust
Data Processor:
NOT APPLICABLE

Usage

Data Use Limitations:
GENERAL RESEARCH USE
Data Use Requirements:
PROJECT SPECIFIC RESTRICTIONS
Resource Creators:
  • This publication uses data from PIONEER
  • an ethically approved database and analytical environment (East Midlands Derby Research Ethics 20/EM/0158)
Is Referenced By:
NOT APPLICABLE

Format and Standards

Vocabulary Encoding Schemes:
  • ICD10
  • SNOMED CT
Conforms To:
LOCAL
Languages:
en
Formats:
SQL

Enrichment and Linkage

Derivations:
NOT APPLICABLE

Observations

Statistical Population
Population Description
Population Size
Measured Property
Observation Date
Events
141,921 same day emergency spells that are completed in 48 hours or less from 2019-04-01 to 2020-09-30
141921
Count
2021-05-17