ArticleEmergency medicine journal : EMJ2020
Waiting times in emergency departments: exploring the factors associated with longer patient waits for emergency care in England using routinely collected daily data.
Article in Emergency medicine journal : EMJ, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 52 citations in OpenAlex.
- Emergency department crowding in the modern era: a systematic review (2018-2025).Clinical and experimental emergency medicine · 2026Pooled it
- Cessation of smoking in people attending UK emergency departments: the COSTED RCT with economic and process evaluation.Health technology assessment (Winchester, England) · 2025Trial
- IMPACT: Integrated Model For Patient Acuity, Care, And Triage Efficiency In Emergency Department.Journal of medical systems · 2026Article
- "Missing the forest for the trees" Is there any crisis of vocation for Emergency Medicine in Italy?Internal and emergency medicine · 2026Article
- The association between long emergency department stays and inpatient length of stay: a retrospective cohort study.BMC emergency medicine · 2026Observational
- Enhancing patient admission efficiency through a hybrid cloud framework for medical record sharing.Scientific reports · 2026Article
- NeuroICU FastTrack: Rapid Disposition of Patients with Intracerebral Hemorrhage from the Emergency Department to Neuro-ICU.Neurocritical care · 2025Article
- Length of stay in the emergency department and its associated input-, throughput-, and output factors at two hospitals in Sweden.BMC emergency medicine · 2025Article
- Developing interpretable machine learning models to predict length of stay and disposition decision for adult patients in emergency departments.BMJ health & care informatics · 2025Article
- The role of confidence/trust in the emergency department.BMC research notes · 2025Article
- Streamlining emergency nursing care post-pandemic: A lean approach for reducing wait times and improving patient and staff satisfaction in the hospital.BMC nursing · 2025Article
- [The utilization of ophthalmological emergency departments is on the rise : 14-year results from a German tertiary university outpatient department].Die Ophthalmologie · 2025Article
- Scoping review of the effectiveness of 10 high-impact initiatives (HIIs) for recovering urgent and emergency care services.BMJ open quality · 2024Article
- Provider perception of presentations with nonspecific back pain in the emergency department and primary care practices: a semi-structured interview study.International journal of emergency medicine · 2024Article
- Reduced Time to Admit Emergency Department Patients to Inpatient Beds Using Outflow Barrier Analysis and Process Improvement.The western journal of emergency medicine · 2024Article
- The influence of waiting times and sociopolitical variables on public trust in healthcare: A cross-sectional study of the NHS in England.Public health in practice (Oxford, England) · 2024Article
- Increasing staff time for patient facing care on an inpatient geriatric unit through modification of multidisciplinary board rounds: a quality improvement project.BMJ open quality · 2023Article
- Socioeconomic status is associated with process times in the emergency department for patients with chest pain.Journal of the American College of Emergency Physicians open · 2023Article
- Length of Stay in Emergency Department by ICD-10 Specific and Non-Specific Diagnoses: A Single-Centre Retrospective Study.Journal of clinical medicine · 2023Article
- Development of an acute medical unit to optimize patient flow and early discharges in a tertiary care hospital in the United Arab Emirates.BMC health services research · 2022Review
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLong lengths of stay (also called waiting times) in emergency departments (EDs) are associated with higher patient mortality and worse outcomes.
objectiveTo add to the literature using high-frequency data from a large number of hospitals to analyse factors associated with long waiting times, including exploring non-linearities for 'tipping points'.
methodsMultivariate ordinary least squares regressions with fixed effects were used to analyse factors associated with the proportion of patients in EDs in England waiting more than 4 hours to be seen, treated and admitted or discharged. Daily situation reports (Sitrep), hospital episode statistics and electronic staffing records data over 90 days between December 2016 and February 2017 were used for all 138 English NHS healthcare providers with a major ED.
resultsHigher inpatient bed occupancy was correlated with longer ED waiting times, with a non-linear association. In a full hospital, with 100% bed occupancy, the proportion of patients who remained in the ED for more than 4 hours was 9 percentage points higher (95% CI 7.5% to 11.1%) than with an 85% occupancy level. For each percentage point change in the following factors, the proportion of ED stays over 4 hours also increased: more inpatients with hospital length of stay over 21 days (0.07%, 95% CI 0.008% to 0.13%); higher emergency admissions (0.08%, 95% CI 0.06% to 0.10%); and lower discharges relative to admissions on the same day (0.04%, 95% CI 0.02% to 0.06%), the following day (0.05%, 95% CI 0.03% to 0.06%) and at 2 days (0.05%, 95% CI 0.04% to 0.07%).
conclusionsThese results suggest that tackling patient flow and capacity in the wider hospital, particularly very high bed occupancy levels and patient discharge, is important to reduce ED waiting times and improve patient outcomes.
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