Evaluating the impact of emergency department crowding on disposition patterns and outcomes of discharged patients
dc.contributor.author | Abir, Mahshid | |
dc.contributor.author | Goldstick, Jason E | |
dc.contributor.author | Malsberger, Rosalie | |
dc.contributor.author | Williams, Andrew | |
dc.contributor.author | Bauhoff, Sebastian | |
dc.contributor.author | Parekh, Vikas I | |
dc.contributor.author | Kronick, Steven | |
dc.contributor.author | Desmond, Jeffrey S | |
dc.date.accessioned | 2019-02-03T04:17:21Z | |
dc.date.available | 2019-02-03T04:17:21Z | |
dc.date.issued | 2019-01-30 | |
dc.identifier.citation | International Journal of Emergency Medicine. 2019 Jan 30;12(1):4 | |
dc.identifier.uri | https://doi.org/10.1186/s12245-019-0223-1 | |
dc.identifier.uri | https://hdl.handle.net/2027.42/147464 | |
dc.description.abstract | Abstract Background Crowding is a major challenge faced by EDs and is associated with poor outcomes. Objectives Determine the effect of high ED occupancy on disposition decisions, return ED visits, and hospitalizations. Methods We conducted a retrospective analysis of electronic health records of patients evaluated at an adult, urban, and academic ED over 20 months between the years 2012 and 2014. Using a logistic regression model predicting admission, we obtained estimates of the effect of high occupancy on admission disposition, adjusted for key covariates. We then stratified the analysis based on the presence or absence of high boarder patient counts. Results Disposition decisions during a high occupancy hour decreased the odds of admission (OR = 0.93, 95% CI: [0.89, 0.98]). Among those who were not admitted, high occupancy was not associated with increased odds of return in the combined (OR = 0.94, 95% CI: [0.87, 1.02]), with-boarders (OR = 0.96, 95% CI: [0.86, 1.09]), and no-boarders samples (OR = 0.93, 95% CI: [0.83, 1.04]). Among those who were not admitted and who did return within 14 days, disposition during a high occupancy hour on the initial ED visit was not associated with a significant increased odds of hospitalization in the combined (OR = 1.04, 95% CI: [0.87, 1.24]), the with-boarders (OR = 1.12, 95% CI: [0.87, 1.44]), and the no-boarders samples (OR = 0.98, 95% CI: [0.77, 1.24]). Conclusion ED crowding was associated with reduced likelihood of hospitalization without increased likelihood of 2-week return ED visit or hospitalization. Furthermore, high occupancy disposition hours with high boarder patient counts were associated with decreased likelihood of hospitalization. | |
dc.title | Evaluating the impact of emergency department crowding on disposition patterns and outcomes of discharged patients | |
dc.type | Article | en_US |
dc.description.bitstreamurl | https://deepblue.lib.umich.edu/bitstream/2027.42/147464/1/12245_2019_Article_223.pdf | |
dc.language.rfc3066 | en | |
dc.rights.holder | The Author(s). | |
dc.date.updated | 2019-02-03T04:17:24Z | |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
Files in this item
Remediation of Harmful Language
The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.
Accessibility
If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.