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Seasonal and regional fluctuations in the demand for Accident and Emergency care in English hospitals

Author

Listed:
  • Forchini, Giovanni

    (Department of Economics, Umeå University)

  • Hauck, Katharina

    (Medical School, Imperial College, London, UK)

  • Steventon, Adam

    (The Health Foundation, London, UK)

Abstract

There is a profusion of evidence on the population and supply side factors explaining demand for emergency care, but surprisingly very little evidence about how seasonal patterns of demand vary across regions. Such information is crucial to help hospitals manage fluctuations in demand and ease capacity constraints. The objective of this study is to analyse the patterns of weekly attendances to Accident and Emergency departments in England, controlling for a wide range of determinants. The study uses both panel and common trend methods on data for 135 English hospitals and their catchment areas merged from a variety of sources over 156 weeks from 2012 to 2015. Modelling of unobservable factors with common trend models shows systematic patterns in the data related to season and the location of providers. Coastal areas experience more attendances in summer than urban areas, and this trend is reversed in winter, possibly due to temporary population movements. Internal reorganizations between major A&E departments and minor injury units within hospitals lead to structural breaks in attendances. In the panel models, only the share of the working population, weather and socioeconomic deprivation are statistically significant predictors of attendances in the panel models. The forecasting ability of both panel and common trends methods is similar. Fine-tuning funding allocations across trusts and seasons according to temporary population movements could be a promising avenue to help alleviate existing capacity constraints emergency departments.

Suggested Citation

  • Forchini, Giovanni & Hauck, Katharina & Steventon, Adam, 2020. "Seasonal and regional fluctuations in the demand for Accident and Emergency care in English hospitals," Umeå Economic Studies 970, Umeå University, Department of Economics.
    • Handle: RePEc:hhs:umnees:0970
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    References listed on IDEAS

    as
    1. Jushan Bai & Josep Lluís Carrion-I-Silvestre, 2009. "Structural Changes, Common Stochastic Trends, and Unit Roots in Panel Data," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 76(2), pages 471-501.
    2. Redding, Stuart & Nicodemo, Catia & Wittenberg, Raphael, 2021. "Analysis of trends in emergency and elective hospital admissions and hospital bed days 1997 to 2015," Social Science & Medicine, Elsevier, vol. 279(C).
    3. Conley, T. G., 1999. "GMM estimation with cross sectional dependence," Journal of Econometrics, Elsevier, vol. 92(1), pages 1-45, September.
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    More about this item

    Keywords

    accident and emergency attendances; seasonal and regional fluctuations; internal migration; common trend analysis; demand/utilization of emergency healthcare;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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