BEYOND THE WEEKLY CENSUS:

1
BEYOND THE WEEKLY CENSUS A CLOSER LOOK AT
PATIENT FACTORS CONTRIBUTING TO EMERGENCY ROOM
USE IN WINNIPEG Romy McMaster, BSc (MSc
Candidate), Anita Kozyrskyj, PhD
(Advisor) Department of Community Health
Sciences, Faculty of Medicine, University of
Manitoba, Winnipeg, Canada
RESULTS
RATIONALE
CONCLUSION This study showed that, beyond simple
visit counts, variation exists across emergency
departments in Winnipeg, across age groups, and
across geographic boundaries. Urgency, admit
rates and lengths of stay increase dramatically
with age.
Each year, approximately 200,000 visits are made
to Adult Emergency Departments in Winnipeg. The
Winnipeg Regional Health Authority publishes a
weekly visit count by hospital, but little else
is reported. What is known about these emergency
patients?
Geographic Distribution of Emergency Department
Visits
Average Daily Number of Visits Per
Hospital Fiscal 01/02
CGH GGH HSC SBGH SOGH VGH
83.6 81.6 104.0 104.8 93.7 85.8
Visit Rate per 1000 population All Age Groups
Number of Visits By Age Group At Each
Hospital Fiscal 01/02 Scheduled Visits Excluded
OBJECTIVE To describe variation in emergency room
use and to identify patient factors that
contribute to Emergency Department workload in
Winnipeg.
Legend Visits Per 1000 Population
100-150
151-200
201-250
251-300
301-350
351-400
401-450
451-500
501-550
551-600
POLICY IMPLICATIONS RECOMMENDATIONS
Use of this database could address research and
policy questions such as Q What is the rate of
early return visits (i.e. within 72 hours) and
what are the outcomes of these patients? Q Are
Emergency Department (ED) users loyal to one
ED? Q What is the average distance (i.e. travel
time) to the most frequently used ED? Q What
is the rate of ED registrants leaving without
being seen by a physician? Q How does ED use
vary over time? Q What is the effect of opening
primary health care centres or urgent care
centres on ED use? Q How does a changing
demographic alter the use of EDs in Winnipeg?
Visit Rate per 1000 population Ages 65
METHODS

• This descriptive study used data systematically
  collected from all six Adult Emergency
  Departments in Winnipeg from April 1, 2001 -
  March 31, 2002.
• Variables available for each emergency room
  registrant included
• Personal Health Information Number (PHIN)
• Date of birth
• Triage level
• Registration date and time
• Discharge date and time
• Discharge status
• Postal code
• (Data from Childrens Emergency and Misericordia
  Urgent Care Centre were not available, although
  visits made by children to adult emergency
  departments were included)

Proportion of Visits by Triage By Age
Group Fiscal 01/02 All Hospitals
Ages 17-44
Ages 85
Linking this database to other information,
including hospital abstracts and physician
claims, could address research and policy
questions such as Q Are frequent users of the
ED frequent users of other health care
services? Q What is the pattern of ED use of
patients when their regular physician is
unavailable (i.e. after office hours)? Q Are
there certain chronic diseases or comorbidities
that increase the likelihood of utilization of
the ED? Q How does ED use vary by income and
other measures of socioeconomic status?
Length of Stay in Hours (From Registration to
Discharge) Fiscal 01/02
Other category includes invalid entries,
resuscitation and direct admits
Admit Rates By Age Group Fiscal 01/02
  All Ages 17-44 45-64 65-74 75-84 85
CGH 11.2 3.1 11.9 23.6 33.1 48.3
GGH 18.9 7.6 17.8 30.1 38.2 44.2
HSC 18.9 13.7 21.4 31.4 37.5 34.7
SBGH 16.2 9.1 16.5 27.6 32.9 40.0
VGH 15.9 7.0 17.2 32.1 43.2 53.4
All Hospitals 16.4 9.1 17.6 28.3 36.3 45.0
ACKNOWLEDGEMENTS
This training opportunity was supported (in part)
by a Western Regional Training Centre studentship
funded by a Canadian Health Services Research
Foundation, Alberta Heritage Foundation for
Medical Research and Canadian Institutes of
Health Research
Due to unreliable information on the discharge
status field from Seven Oaks General Hospital
(SOGH), it was not included in the analysis
I would also like to acknowledge the support and
guidance of Mr. Randy Martens, Administrative
Director of the Winnipeg Regional Health
Authority Emergency Critical Care Programs.
CGH Concordia General Hospital / GGH Grace
General Hospital / HSC Health Sciences Centre /
SBGH St. Boniface General Hospital / SOGH
Seven Oaks General Hospital / VGH Victoria
General Hospital