Tools
Tools
Memtsa, M, Goodhart, V, Ambler, G, Brocklehurst, P, Keeney, E, Silverio, SA, Anastasiou, Z, Round, J, Khan, N, Hall, J, Barrett, G, Bender-Atik, R, Stephenson, J and Jurkovic, D (2021) Differences in the organisation of early pregnancy units and the effect of senior clinician presence, volume of patients and weekend opening on emergency hospital admissions: Findings from the VESPA Study. PLoS One, 16 (11). ISSN 1932-6203
|
Text
Differences in the organisation of early pregnancy units and the effect of senior clinician presence, volume of patients and.pdf - Published Version Available under License Creative Commons Attribution. Download (601kB) | Preview |
Abstract
Objective To determine whether the participation of consultant gynaecologists in delivering early pregnancy care results in a lower rate of acute hospital admissions. Design Prospective cohort study and emergency hospital care audit; data were collected as part of the national prospective mixed-methods VESPA study on the "Variations in the organization of EPAUs in the UK and their effects on clinical, Service and PAtient-centred outcomes". Setting 44 Early Pregnancy Assessment Units (EPAUs) across the UK randomly selected in balanced numbers from eight pre-defined mutually exclusive strata. Participants 6606 pregnant women (≥16 years old) with suspected first trimester pregnancy complications attending the participating EPAUs or Emergency Departments (ED) from December 2016 to July 2017. Exposures Planned and actual senior clinician presence, unit size, and weekend opening. Main outcome measures Unplanned admissions to hospital following any visit for investigations or treatment for first trimester complications as a proportion of women attending EPAUs. Results 205/6397 (3.2%; 95% CI 2.8-3.7) women were admitted following their EPAU attendance. The admission rate among 44 units ranged from 0% to 13.7% (median 2.8). Neither planned senior clinician presence (p = 0.874) nor unit volume (p = 0.247) were associated with lower admission rates from EPAU, whilst EPAU opening over the weekend resulted in lower admission rates (p = 0.027). 1445/5464 (26.4%; 95%CI 25.3 to 27.6) women were admitted from ED. There was little evidence of an association with planned senior clinician time (p = 0.280) or unit volume (p = 0.647). Keeping an EPAU open over the weekend for an additional hour was associated with 2.4% (95% CI 0.1% to 4.7%) lower odds of an emergency admission from ED. Conclusions Involvement of senior clinicians in delivering early pregnancy care has no significant impact on emergency hospital admissions for early pregnancy complications. Weekend opening, however, may be an effective way of reducing emergency admissions from ED.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Humans; Pregnancy Complications; Patient Admission; Prenatal Care; Prospective Studies; Pregnancy; Pregnancy Trimester, First; Adolescent; Adult; Physicians; Emergency Service, Hospital; Female; Adolescent; Adult; Emergency Service, Hospital; Female; Humans; Patient Admission; Physicians; Pregnancy; Pregnancy Complications; Pregnancy Trimester, First; Prenatal Care; Prospective Studies; General Science & Technology |
| Subjects: | B Philosophy. Psychology. Religion > BF Psychology R Medicine > RG Gynecology and obstetrics |
| Divisions: | Psychology (from Sep 2019) |
| Publisher: | Public Library of Science |
| SWORD Depositor: | A Symplectic |
| Date Deposited: | 09 Dec 2022 11:46 |
| Last Modified: | 09 Dec 2022 11:46 |
| DOI or ID number: | 10.1371/journal.pone.0260534 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/18305 |
 |
View Item |