Research Activities, August 2013
Patients admitted to the hospital when the emergency department is crowded more likely to die during their hospital stay
Emergency department patients admitted to the hospital on days when the emergency department (ED) is crowded, have a 5 percent greater odds of dying after being admitted to the hospital, reveals a new study. These patients also had 0.8 percent longer hospital stays and 1 percent increase in costs per admission.
The researchers collected hospital discharge data on 995,379 admissions from EDs during 1 year at 187 hospitals in California. ED overcrowding was determined by using daily ambulance diversion hours on the day of each admission. (Ambulances are typically diverted to other EDs when one is overcrowded). Overcrowding resulted in 300 inpatient deaths, 6,200 additional hospital days, and $17 million in extra costs during the 1-year period.
According to the researchers, ED crowding is a marker for worse care for all ED patients who may require admission. With an aging population and slow growth in the number of new EDs, overcrowding is likely to continue and even become worse. The researchers call for more effort by policymakers to develop national policy responses to this growing public health problem. The study was supported in part by AHRQ (HS18098).
See "Effect of emergency department crowding on outcomes of admitted patients," by Benjamin C. Sun, M.D., M.P.P., Renee Y. Hsia, M.D., Robert E. Weiss, Ph.D., and others in the December 5, 2012, Annals of Emergency Medicine [Epub ahead of print].