Length of stay in EDs: variation across classifications of clinical condition and patient discharge disposition - 14/12/15
, Marguerite L. Barrett, MS d, Kendall K. Hall, MD, MS eAbstract |
Study objective |
Duration of a stay in an emergency department (ED) is considered a measure of quality, but current measures average lengths of stay across all conditions. Previous research on ED length of stay has been limited to a single condition or a few hospitals. We use a census of one state’s data to measure length of ED stays by patients’ conditions and dispositions and explore differences between means and medians as quality metrics.
Methods |
The data source was the Healthcare Cost and Utilization Project 2011 State Emergency Department Databases and State Inpatient Databases for Florida. Florida is unique in collecting ED length of stay for both released and admitted patients. Clinical Classifications Software was used to group visits based on first-listed International Classification of Disease, Ninth Edition, Clinical Modification, diagnoses.
Results |
For the 10 most common diagnoses, patients with relatively minor injuries typically required the shortest mean stay (3 hours or less); conditions resulting in admission or transfer tended to be more serious, resulting in longer stays. Patients requiring the longest stays, by disposition, had discharge diagnoses of nonspecific chest pain (mean 7.4 hours among discharged patients), urinary tract infections (4.8 hours among admissions), and schizophrenia (9.6 hours among transfers) among the top 10 diagnoses.
Conclusion |
Emergency department length of stay as a measure of ED quality should take into account the considerable variation by condition and disposition of the patient. Emergency department length of stay measurement could be improved in the United States by standardizing its definition; distinguishing visits involving treatment, observation, and boarding; and incorporating more distributional information.
Le texte complet de cet article est disponible en PDF.Plan
| ☆ | Meetings: This work was presented at the Society for Academic Emergency Medicine 2014 Annual Meeting as an oral presentation by BM and at the Academy Health 2014 Annual Research Meeting as a poster presentation by EM. |
| ☆☆ | Funding: This study was funded by the Agency for Healthcare Research and Quality under a contract to Truven Health Analytics to develop and support the Healthcare Cost and Utilization Project (contract no. HHSA-290-2013-00002-C). The views expressed in this article are those of the authors and do not necessarily reflect those of the Agency for Healthcare Research and Quality or the US Department of Health and Human Services. |
| ★ | Conflicts of interest: The authors have no conflicts of interest to report. |
Vol 34 - N° 1
P. 83-87 - janvier 2016 Retour au numéro
Article précédent
- ECG abnormalities predict neurogenic pulmonary edema in patients with subarachnoid hemorrhage
- Wei-Lung Chen, Chi-Hung Huang, Jiann-Hwa Chen, Henry Chih-Hung Tai, Su-Hen Chang, Yung-Cheng Wang
- Development of a prehospital vital signs chart sharing system
- Taka-aki Nakada, Naohisa Masunaga, Shota Nakao, Maiko Narita, Takashi Fuse, Hiroaki Watanabe, Yasuaki Mizushima, Tetsuya Matsuoka
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?