The impact of delays to admission from the emergency department on inpatient outcomes

BMC Emergency Medicine

Research Article

Qing Huang¹  Amardeep Thind²  Jonathan F Dreyer³  Gregory S Zaric⁴ 

[1] Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, Canada;Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, Canada;Department of Family Medicine, Schulich School of Medicine and Dentistry University of Western Ontario, Canada;Division of Emergency Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, Canada;Richard Ivey School of Business, University of Western Ontario, Canada;Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, Canada;

关键词: Emergency Department;    Delayed Patient;    Initial Acuity;    Discharge Abstract Database;    Emergency Department Triage;   

DOI  :  10.1186/1471-227X-10-16

 received in 2010-01-31, accepted in 2010-07-09,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundWe sought to determine the impact of delays to admission from the Emergency Department (ED) on inpatient length of stay (LOS), and IP cost.MethodsWe conducted a retrospective analysis of 13,460 adult (≥ 18 yrs) ED visits between April 1 2006 and March 30 2007 at a tertiary care teaching hospital with two ED sites in which the mode of disposition was admission to ICU, surgery or inpatient wards. We defined ED Admission Delay as ED time to decision to admit > 12 hours. The primary outcomes were IP LOS, and total IP cost.ResultsApproximately 11.6% (n = 1558) of admitted patients experienced admission delay. In multivariate analysis we found that admission delay was associated with 12.4% longer IP LOS (95% CI 6.6% - 18.5%) and 11.0% greater total IP cost (6.0% - 16.4%). We estimated the cumulative impact of delay on all delayed patients as an additional 2,183 inpatient days and an increase in IP cost of $2,109,173 at the study institution.ConclusionsDelays to admission from the ED are associated with increased IP LOS and IP cost. Improving patient flow through the ED may reduce hospital costs and improve quality of care. There may be a business case for investments to reduce emergency department admission delays.

【 授权许可】

Unknown   
© Huang et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.