Case fatality ratios for serious emergency conditions in the Republic of Ireland: a longitudinal investigation of trends over the period 2002-2014 using joinpoint analysis

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dc.contributor.author Lynch, Brenda
dc.contributor.author Fitzgerald, Anthony P.
dc.contributor.author Corcoran, Paul
dc.contributor.author Healy, Orla
dc.contributor.author Buckley, Claire M.
dc.contributor.author Foley, Conor
dc.contributor.author Browne, John P.
dc.date.accessioned 2018-10-12T15:17:51Z
dc.date.available 2018-10-12T15:17:51Z
dc.date.issued 2018-06-19
dc.identifier.citation Lynch, B., Fitzgerald, A. P., Corcoran, P., Healy, O., Buckley, C., Foley, C. and Browne, J. (2018) 'Case fatality ratios for serious emergency conditions in the Republic of Ireland: a longitudinal investigation of trends over the period 2002–2014 using joinpoint analysis', BMC Health Services Research, 18(1), 474 (12 pp). doi:10.1186/s12913-018-3260-1 en
dc.identifier.volume 18 en
dc.identifier.startpage 474-1 en
dc.identifier.endpage 474-12 en
dc.identifier.issn 1472-6963
dc.identifier.uri http://hdl.handle.net/10468/7009
dc.identifier.doi 10.1186/s12913-018-3260-1
dc.description.abstract Background: In the past decade, the Republic of Ireland has undertaken significant reconfiguration programmes to improve emergency services. During this time the public healthcare system experienced a large real decrease in resources. This study assesses national and regional population outcomes over the period 2002–2014, and whether changes coincide with system reconfiguration and the financial restrictions imposed by the 2008 recession. Methods: Case fatality ratios (CFRs) were constructed for emergency conditions for 2002–2014. Total emergency conditions and individual condition trends were analysed nationally using joinpoint analysis. National results informed the investigation of trends at a regional and county level using an inverse standard error weighted generalised linear model with a log link to construct funnel plots. County-level CFRs were compared for the first and last 3 years of the period to further investigate the changes to county results over the 13 year period, specifically in comparison to the national-level CFR. Results: Nationally, there was an annual fall in CFRs (2.1%). The decline was faster from 2002 to 2007 (annual percentage change = − 3.4; 95% CI-4.4, − 2.4), compared to 2007–2014 (annual percentage change = − 1.2; 95% CI -1.9, − 0.5). The South-East had a lower rate of decrease and the West had a higher rate. Cross sectional analysis of two periods (2002–2004 and 2012–2014) showed high consistency in the counties performance relative to the national CFR in both periods. Conclusion: Change in the national trend coincided with the onset of economic stress on the public health system. Attributing the decline in CFR improvement to economic factors is weakened by the uneven nature of the trend change. No distinct pattern of change was identified among regions which underwent substantial reconfiguration of emergency services. en
dc.description.sponsorship Health Research Board, and University College Cork (HRB “Funding University College Cork Collaborative Applied Research Grant 2012” (CARG/ 2012/28)) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher BioMed Central en
dc.relation.uri https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3260-1
dc.rights © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. en
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ en
dc.subject Reconfiguration en
dc.subject Emergency care en
dc.subject Health systems en
dc.subject Regional variations en
dc.subject Acute myocardial-infarction en
dc.subject Mortality en
dc.subject Deprivation en
dc.subject England en
dc.subject Stroke en
dc.subject Wales en
dc.subject Guidelines en
dc.subject Distance en
dc.title Case fatality ratios for serious emergency conditions in the Republic of Ireland: a longitudinal investigation of trends over the period 2002-2014 using joinpoint analysis en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Brenda Lynch, Centre For Policy Studies, University College Cork, Cork, Ireland. +353-21-490-3000 Email: brendalynch@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2018-10-12T12:04:27Z
dc.description.version Published Version en
dc.internal.rssid 444195206
dc.internal.wokid WOS:000435860300007
dc.contributor.funder Health Research Board en
dc.contributor.funder University College Cork en
dc.description.status Peer reviewed en
dc.identifier.journaltitle BMC Health Services Research en
dc.internal.copyrightchecked Yes en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress brendalynch@ucc.ie en
dc.internal.IRISemailaddress j.browne@ucc.ie en


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© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Except where otherwise noted, this item's license is described as © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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