10 December 2012

Nigeria: Crowded Emergency Departments Cause More Deaths, Costs

Excessive crowding in the hospital accident and emergency department is associated with increased inpatient mortality, as well as moderate rises in length of stay and costs, concludes a new study in the Annals of Emergency Medicine.

Findings reveal that patients admitted to the hospital during high emergency department crowding times had five percent greater risk of inpatient death than similar patients admitted to the same hospital when there is less crowding.

The researchers looked at almost one million emergency department visits resulting in admission to 187 hospitals and used daily ambulance diversion to measure emergency department crowding, according to a new research.

They found that on days with a median of seven ambulance diversion hours, admitted patients had a 0.8 percent longer hospital length of stay and 1 percent higher costs.

Moreover, high emergency department crowding was associated with 300 excess inpatient deaths, 6,200 hospital days and $17 million in costs, the study noted.

Such findings are even more worrisome, given that most emergency departments tend to be overcrowded.

Most crowding stems from emergency department boarding, in which emergency patients admitted to the hospital are waiting for an inpatient bed, it was gathered.

Researchers say the new study reinforces calls to end emergency department boarding. "Prolonged boarding times may delay definitive testing and increase short-term mortality, length of stay, and associated costs," the study states.

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