Processes and outcomes in patients presenting to the emergency department, stratified by multimorbidity status
| No. of patients | All (n=451 291) | No multimorbidity (n=407 787) | Multimorbidity (n=43 504) | P value |
| Departmental outcomes | ||||
| Time (mins) to be seen: | ||||
| Median (interquartile range) | 76 (40-121) | 76.3 (41-122) | 68 (34-113) | <0.001 |
| Mean (SD) | 84.6 (55.4) | 85.4 (55.4) | 78.1 (54.6) | — |
| Seen by HCP within four hours, No. (%)*: | ||||
| No | 2680 (0.7) | 2448 (0.8) | 232 (0.6) | 0.005 |
| Yes | 355 490 (99.3) | 318 899 (99.2) | 36 591 (99.4) | — |
| Hours spent in emergency department: | ||||
| Median (interquartile range) | 3.4 (2.3-4.3) | 3.3 (2.3-4.2) | 4 (3.2-4.9) | <0.001 |
| Mean (SD) | 3.4 (1.6) | 3.3 (1.6) | 4.3 (1.9) | — |
| Left emergency department within four hours, No. (%)*: | ||||
| No | 119 183 (33.3) | 100 566 (31.3) | 18 617 (50.6) | <0.001 |
| Yes | 238 953 (66.7) | 220 753 (68.7) | 18 200 (49.4) | — |
| Discharge outcomes | ||||
| Discharge destination, No. (%): | ||||
| Admission to critical care or critical care unit | 6231 (1.4) | 5049 (1.2) | 1182 (2.7) | <0.001 |
| Admission to hospital ward | 103 519 (22.9) | 78 565 (19.3) | 24 954 (57.4) | — |
| Died before hospital admission | 1350 (0.3) | 962 (0.2) | 388 (0.9) | — |
| Home | 295 950 (65.6) | 280 714 (68.8) | 15 236 (35.0) | — |
| Outpatient clinic/ambulatory care | 44 241 (9.8) | 42 497 (10.4) | 1744 (4.0) | — |
| Level of care admitted to, No. (%): | ||||
| Critical care unit | 1930 (0.4) | 1667 (0.4) | 263 (0.6) | <0.001 |
| High dependency units | 1756 (0.4) | 1285 (0.3) | 471 (1.1) | — |
| Intensive care units | 2545 (0.6) | 2097 (0.5) | 448 (1.0) | — |
| Non-critical care | 103 519 (22.9) | 78 565 (19.3) | 24 954 (57.4) | — |
| Not admitted | 341 541 (75.7) | 324 173 (79.5) | 17 368 (39.9) | — |
| Hospital length of stay (days)† | ||||
| Median (interquartile range) | 3 (1-8) | 2 (1-6.5) | 4.5 (1.5-13) | <0.001 |
| Mean (SD) | 9.9 (24.8) | 8.7 (23.6) | 13.7 (28.2) | —— |
| Repeat emergency department presentation within seven days, No. (%)‡: | ||||
| No | 325 326 (96.3) | 309 773 (96.5) | 15 553 (92.2) | <0.001 |
| Yes | 12 539 (3.7) | 11 218 (3.5) | 1321 (7.8) | — |
| Mortality outcomes | ||||
| Died within 24 h of presentation, No. (%): | ||||
| Died | 2188 (0.5) | 1445 (0.4) | 743 (1.7) | <0.001 |
| Survived | 449 103 (99.5) | 406 342 (99.6) | 42 761 (98.3) | — |
| Died within seven days of presentation, No. (%): | ||||
| Died | 4912 (1.1) | 3011 (0.7) | 1901 (4.4) | <0.001 |
| Survived | 446 379 (98.9) | 404 776 (99.3) | 41 603 (95.6) | — |
| Died within 30 days of presentation, No. (%): | ||||
| Died | 8516 (1.9) | 4969 (1.2) | 3547 (8.2) | <0.001 |
| Survived | 442 775 (98.1) | 402 818 (98.8) | 39 957 (91.8) | — |
| In-hospital mortality†, No. (%): | ||||
| Died | 6444 (6.1) | 3638 (4.6) | 2806 (11.0) | <0.001 |
| Survived | 98 720 (93.9) | 75 993 (95.4) | 22 727 (89.0) | — |
P value indicates unadjusted significance testing between patients with multimorbidity and patients who did not have multimorbidity. For categorical variables, we used χ2, and for continuous variables, we used Mann-Whitney testing.
*This statistic only applies to patients for whom the four hour rule is applicable.
†This statistic only applies to patients who were admitted to hospital.
‡This statistic only applies to patients who were discharged alive from emergency department and were not admitted to hospital.
HCP, healthcare professional; SD, standard deviation.