Significant changes in emergency department length of stay and case mix over eight years at a large Swedish University Hospital.
Int Emerg Nurs
; 43: 50-55, 2019 Mar.
Article
en En
| MEDLINE
| ID: mdl-30190224
ABSTRACT
OBJECTIVE:
Describe the longitudinal development of crowding and patient/emergency department (ED) characteristics at a Swedish University Hospital.METHODS:
A retrospective longitudinal registry study based on all ED visits with adult patients during 2009-2016 (Nâ¯=â¯1,063,806). Patient characteristics and measures of ED crowding (ED occupancy ratio, length-of-stay [LOS], patients/clinician's ratios) were extracted from the hospital's electronic health record. Non-parametric analyses were conducted.RESULTS:
The proportion of unstable patients (triage level 1-2) increased while the proportion of admitted patients decreased. All crowding variables were stable, except for LOS, which increased by 9â¯min/visit/year (95% CI 8.8-9.1). LOS for visits by patientsâ¯≥â¯80â¯years increased more compared to those 18-79 (248â¯min vs. 190â¯min, pâ¯<â¯0.001). Unstable patients increased their median LOS compared to stable patients (triage level 3-5). LOS for discharged patients increased with an average of 7.7â¯min/year (95% CI 7.5-7.9) compared to 15.5â¯min/year (95% CI 15.2-15.8) for those being admitted.CONCLUSION:
Fewer admissions, despite an increase of unstable patients, is likely related to lack of in-hospital beds and contributes to ED crowding. The increase in median ED LOS, especially for patients in the subgroups unstable, ≥80â¯years and admitted to in-hospital care reflects this problem.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Factores de Tiempo
/
Servicio de Urgencia en Hospital
/
Tiempo de Internación
Tipo de estudio:
Observational_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Int Emerg Nurs
Asunto de la revista:
ENFERMAGEM
/
MEDICINA DE EMERGENCIA
Año:
2019
Tipo del documento:
Article