ArticleAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2014
Increases in emergency department occupancy are associated with adverse 30-day outcomes.
Article in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 47 papers, 3 of them syntheses that pooled it.
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Who cites it
47 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Effectiveness of interventions to alleviate emergency department crowding by older adults: a systematic review.BMC emergency medicine · 2019Pooled it
- Challenges, consequences, and lessons for way-outs to emergencies at hospitals: a systematic review study.BMC emergency medicine · 2019Pooled it
- Emergency department crowding: A systematic review of causes, consequences and solutions.PloS one · 2018Pooled it
- Patients' experiences of receiving hospital care from a mobile care unit - a qualitative interview study.International journal of qualitative studies on health and well-being · 2026Article
- Association between emergency department crowding and mortality: a nationwide analysis stratified by emergency department levels: a retrospective cohort study.BMC emergency medicine · 2026Article
- Innovative telehospitalist model optimizes medical triage in collaboration with community emergency departments: A cross-sectional study.Journal of telemedicine and telecare · 2026Article
- Lessons from a large national "hospital at home" program.Israel journal of health policy research · 2025Article
- Design and cost-effectiveness assessment of a model based on point-of-care testing for the improvement of the resolution of hospital emergencies.Advances in laboratory medicine · 2025Article
- Article
- Emergency Department Disposition and Point-of-Care Ultrasound in Biliary Disease: Propensity-Weighted Cohort Study.The western journal of emergency medicine · 2025Article
- Invited Editorial: Waiting Room Care is Not the Solution to Emergency Department Boarding.Journal of the American College of Emergency Physicians open · 2025Article
- Building a public-private partnership to confront the emergency department boarding crisis.Health affairs scholar · 2025Article
- Emergency department crowding: a national data report.Clinical and experimental emergency medicine · 2024Article
- Article
- Article
- Association of emergency department crowding with inpatient outcomes.Health services research · 2023Article
- Ochsner Emergency Department Overcrowding Scale (OEDOCS): predicting Emergency Department crowding among diverse academic hospital settings.AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science · 2023Article
- Emergency department crowding and mortality: an observational multicenter study in Sweden.Frontiers in public health · 2023Article
- Effects of Emergency Transfer Coordination Center on Length of Stay of Critically Ill Patients in the Emergency Department.The western journal of emergency medicine · 2022Observational
- Reducing Unnecessary 'Admission' Chest X-rays: An Initiative to Minimize Low-Value Care.Cureus · 2022Article
Corrections and comments
- Commented on by
- Erratum issuedErratum.2015
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe associations between emergency department (ED) crowding and patient outcomes have not been investigated comprehensively in different types of ED. The study objective was to examine the associations of changes over time in ED occupancy with patient outcomes in a sample of EDs that vary by size and location. A secondary objective was to explore whether the relationship between ED occupancy and patient outcomes differed by ED characteristics (size/type and medical and nursing staffing ratios).
methodsUsing linked administrative databases, the authors constructed a cohort of 677,475 patients who visited one of 42 hospital EDs with complete data for 2005 on ED bed and waiting room occupancy. Crowding was measured with the relative occupancy ratio separately for ED bed and waiting room patients, defined as the ratio of ED occupancy on the day of the index ED visit to the average annual occupancy at that same ED. Multivariable logistic regression (adjusting for patient and ED characteristics) was used to analyze 30-day outcomes: mortality, return ED visits, and hospital admission at the first return ED visit.
resultsAfter adjustment for ED and patient characteristics, a 10% increase in ED bed relative occupancy ratio was associated with 3% increases in death and hospital admission at a return visit. A 10% increase in ED waiting room crowding was associated with a small decrease in return visits. There was a stronger association between bed crowding and mortality among larger EDs.
conclusionsIn Quebec EDs, increases in bed occupancy are associated with an increase in the rates of 30-day adverse outcomes, even after adjustment for patient and ED characteristics. The results raise important concerns about the quality of care during periods of ED crowding.
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Registered trials
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