| Mid-Term Effects of Tertiary Hospital Beds Expansion on Emergency Department Overcrowding |
| Ki Wook Kim, Soo Hyun Kim, Kyu Nam Park, Han Joon Kim, Sang Hoon Oh, Ju Young Lee, Jung Min Lee, Jee Yong Im |
1Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. emksh77@gmail.com
2Emergency Team, Emergency Medical Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. |
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| ABSTRACT |
PURPOSE:
Emergency department (ED) overcrowding is recognized as a major concern not only because it is associated with patient dissatisfaction, but also because it impinges on quality of care. The goal of this study is to evaluate the mid-term effects of hospital bed capacity expansion on overcrowding in the emergency department for two years.
METHODS:
This was a pre-post study conducted using administrative data from the ED. On May 1st, 2011, the hospital licensed beds were expanded from 1150 to 1300. Data from one year of the pre-expansion period (May 1st, 2010 to April 30th, 2011) and two years of post-expansion were divided into two periods; early period and late period were included for this analysis. In these periods, we calculated the National Emergency Department Overcrowding Scale (NEDOCS) and occupancy rate at the same time of every day.
The main outcomes included length of stay (LOS) in the ED and NEDOCS.
RESULTS:
A total of 177,766 patients were included. The mean number of daily ED patients was increased; 156.3+/-32.5 in the pre-expansion period, 162.5+/-32.5 and 167.9+/-32.4 in the early and late post-expansion periods, respectively (p<0.001). In multivariate linear regression analysis, hospital bed expansion, the number of admission hold patients, age, number of admission patients and operating rate of hospital beds showed association with mean ED LOS (coefficient=-82.9, 2.7, 6.4, 11.4 and 5.4 respectively, R2=0.628, p<0.001).
CONCLUSION:
Expansion of hospital beds could be helpful in resolving ED overcrowding for at least two years. |
| Key words:
Emergency service, Hospital, Crowding, Bed occupancy, Tertiary care centers |
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