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.contributor.funder	Health Research Board	en
dc.contributor.funder	University College Cork	en
dc.date.accessioned	2018-10-12T15:17:51Z
dc.date.available	2018-10-12T15:17:51Z
dc.date.issued	2018-06-19
dc.date.updated	2018-10-12T12:04:27Z
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.description.status	Peer reviewed	en
dc.description.version	Published Version	en
dc.format.mimetype	application/pdf	en
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.doi	10.1186/s12913-018-3260-1
dc.identifier.endpage	474-12	en
dc.identifier.issn	1472-6963
dc.identifier.journaltitle	BMC Health Services Research	en
dc.identifier.startpage	474-1	en
dc.identifier.uri	https://hdl.handle.net/10468/7009
dc.identifier.volume	18	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

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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