Details

Autor(en) / Beteiligte

• Berg, Lena M.
• Ehrenberg, Anna
• Florin, Jan
• Östergren, Jan
• Göransson, Katarina E.

Titel

Significant changes in emergency department length of stay and case mix over eight years at a large Swedish University Hospital

Ist Teil von

• International emergency nursing, 2019-03, Vol.43, p.50-55

Ort / Verlag

London: Elsevier Ltd

Erscheinungsjahr

2019

Link zum Volltext

Quelle

Applied Social Sciences Index & Abstracts (ASSIA)

Beschreibungen/Notizen

• •A change in case mix occurred, primarily with an increase in unstable patients.•Median for all crowding variables, except LOS, were stable over the study period.•Median LOS increased by an average of 9 min/visit/year.•Median LOS increased most among patient groups ≥ 80 years, unstable and admitted.•ED crowding seemed to high extent be related to lack of in-hospital beds. Describe the longitudinal development of crowding and patient/emergency department (ED) characteristics at a Swedish University Hospital. A retrospective longitudinal registry study based on all ED visits with adult patients during 2009–2016 (N = 1,063,806). Patient characteristics and measures of ED crowding (ED occupancy ratio, length-of-stay [LOS], patients/clinician’s ratios) were extracted from the hospital’s electronic health record. Non-parametric analyses were conducted. The proportion of unstable patients (triage level 1–2) increased while the proportion of admitted patients decreased. All crowding variables were stable, except for LOS, which increased by 9 min/visit/year (95% CI: 8.8–9.1). LOS for visits by patients ≥ 80 years increased more compared to those 18–79 (248 min vs. 190 min, p < 0.001). Unstable patients increased their median LOS compared to stable patients (triage level 3–5). LOS for discharged patients increased with an average of 7.7 min/year (95% CI: 7.5–7.9) compared to 15.5 min/year (95% CI: 15.2–15.8) for those being admitted. Fewer admissions, despite an increase of unstable patients, is likely related to lack of in-hospital beds and contributes to ED crowding. The increase in median ED LOS, especially for patients in the subgroups unstable, ≥80 years and admitted to in-hospital care reflects this problem.