Emergency Department Crowding Disparity: a Nationwide Cross-Sectional Study.
10.3346/jkms.2016.31.8.1331
- Author:
Won Chul CHA
1
;
Ki Ok AHN
;
Sang Do SHIN
;
Jeong Ho PARK
;
Jin Sung CHO
Author Information
1. Department of Emergency Medicine, Samsung Medical Center, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Emergency Service;
Hospital;
Crowding;
National Health Program
- MeSH:
Adolescent;
Adult;
Aged;
Child;
Child, Preschool;
Cross-Sectional Studies;
Databases, Factual;
Emergency Service, Hospital/*statistics & numerical data;
Female;
Hospitalization;
Humans;
Male;
Middle Aged;
Nurses/statistics & numerical data;
Patient Transfer/statistics & numerical data;
Republic of Korea;
Young Adult
- From:Journal of Korean Medical Science
2016;31(8):1331-1336
- CountryRepublic of Korea
- Language:English
-
Abstract:
In this study, we evaluated national differences in emergency department (ED) crowding to identify factors significantly associated with crowding in institutes and communities across Korea. This was a cross-sectional nationwide observational study using data abstracted from the National Emergency Department Information System (NEDIS). We calculated mean occupancy rates to quantify ED crowding status and divided EDs into three groups according to their occupancy rates (cutoffs: 0.5 and 1.0). Factors potentially related to ED crowding were collected from the NEDIS. We performed a multivariate regression analysis to identify variables significantly associated with ED crowding. A total of 120 EDs were included in the final analysis. Of these, 73 were categorized as 'low crowded' (LC, occupancy rate < 0.50), 37 as 'middle crowded' (MC, 0.50 ≤ occupancy rate < 1.00), 10 EDs as 'high crowded' (HC, 1.00 ≤ occupancy rate). The mean ED occupancy rate varied widely, from 0.06 to 2.33. The median value was 0.39 with interquartile ranges (IQRs) from 0.20 to 0.71. Multivariate analysis revealed that after adjustment, ED crowding was significantly associated with the number of visits, percentage of patients referred, number of nurses, and ED disposition. This nationwide study observed significant variety in ED crowding. Several input, throughput, and output factors were associated with crowding.