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Emergency Department Overcrowding and Ambulance Turnaround Time.

Lee YJ, Shin SD, Lee EJ, Cho JS, Cha WC - PLoS ONE (2015)

Bottom Line: The MLM analysis showed that an increase of 1% in occupancy rate was associated with 0.02-minute decrease in turnaround interval (95% CI: 0.01 to 0.03).In this study, we found wide variation in emergency department crowding in a metropolitan Korean city.Our data indicate that ED overcrowding is negatively associated with turnaround interval with very small practical significance.

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea; Department of Social and Preventive Medicine, Inha University Graduate School of Medicine, Seoul, Korea.

ABSTRACT

Objective: The aims of this study were to describe overcrowding in regional emergency departments in Seoul, Korea and evaluate the effect of crowdedness on ambulance turnaround time.

Methods: This study was conducted between January 2010 and December 2010. Patients who were transported by 119-responding ambulances to 28 emergency centers within Seoul were eligible for enrollment. Overcrowding was defined as the average occupancy rate, which was equal to the average number of patients staying in an emergency department (ED) for 4 hours divided by the number of beds in the ED. After selecting groups for final analysis, multi-level regression modeling (MLM) was performed with random-effects for EDs, to evaluate associations between occupancy rate and turnaround time.

Results: Between January 2010 and December 2010, 163,659 patients transported to 28 EDs were enrolled. The median occupancy rate was 0.42 (range: 0.10-1.94; interquartile range (IQR): 0.20-0.76). Overcrowded EDs were more likely to have older patients, those with normal mentality, and non-trauma patients. Overcrowded EDs were more likely to have longer turnaround intervals and traveling distances. The MLM analysis showed that an increase of 1% in occupancy rate was associated with 0.02-minute decrease in turnaround interval (95% CI: 0.01 to 0.03). In subgroup analyses limited to EDs with occupancy rates over 100%, we also observed a 0.03 minute decrease in turnaround interval per 1% increase in occupancy rate (95% CI: 0.01 to 0.05).

Conclusions: In this study, we found wide variation in emergency department crowding in a metropolitan Korean city. Our data indicate that ED overcrowding is negatively associated with turnaround interval with very small practical significance.

No MeSH data available.


Related in: MedlinePlus

demonstrates the association between the average turnaround time and occupancy rate at the emergency department level.Spearman’s rho was 0.58 (P = 0.002). *95% CI: 95% confidence interval
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pone.0130758.g002: demonstrates the association between the average turnaround time and occupancy rate at the emergency department level.Spearman’s rho was 0.58 (P = 0.002). *95% CI: 95% confidence interval

Mentions: The association between occupancy rate and turnaround time for ED level is shown in Fig 2. Occupancy rate and turnaround time were positively associated (Spearman’s rho = 0.58; P = 0.002). However, the relationship within each ED differed widely. Traveling distance was also different among EDs. The within ED variation of turn-around time and distance was displayed in S1 Fig, and S2 Fig. In Fig 3, the circadian variation in turnaround time and occupancy rate is shown. Both turnaround time and occupancy rate increased during the daytime.


Emergency Department Overcrowding and Ambulance Turnaround Time.

Lee YJ, Shin SD, Lee EJ, Cho JS, Cha WC - PLoS ONE (2015)

demonstrates the association between the average turnaround time and occupancy rate at the emergency department level.Spearman’s rho was 0.58 (P = 0.002). *95% CI: 95% confidence interval
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4482653&req=5

pone.0130758.g002: demonstrates the association between the average turnaround time and occupancy rate at the emergency department level.Spearman’s rho was 0.58 (P = 0.002). *95% CI: 95% confidence interval
Mentions: The association between occupancy rate and turnaround time for ED level is shown in Fig 2. Occupancy rate and turnaround time were positively associated (Spearman’s rho = 0.58; P = 0.002). However, the relationship within each ED differed widely. Traveling distance was also different among EDs. The within ED variation of turn-around time and distance was displayed in S1 Fig, and S2 Fig. In Fig 3, the circadian variation in turnaround time and occupancy rate is shown. Both turnaround time and occupancy rate increased during the daytime.

Bottom Line: The MLM analysis showed that an increase of 1% in occupancy rate was associated with 0.02-minute decrease in turnaround interval (95% CI: 0.01 to 0.03).In this study, we found wide variation in emergency department crowding in a metropolitan Korean city.Our data indicate that ED overcrowding is negatively associated with turnaround interval with very small practical significance.

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea; Department of Social and Preventive Medicine, Inha University Graduate School of Medicine, Seoul, Korea.

ABSTRACT

Objective: The aims of this study were to describe overcrowding in regional emergency departments in Seoul, Korea and evaluate the effect of crowdedness on ambulance turnaround time.

Methods: This study was conducted between January 2010 and December 2010. Patients who were transported by 119-responding ambulances to 28 emergency centers within Seoul were eligible for enrollment. Overcrowding was defined as the average occupancy rate, which was equal to the average number of patients staying in an emergency department (ED) for 4 hours divided by the number of beds in the ED. After selecting groups for final analysis, multi-level regression modeling (MLM) was performed with random-effects for EDs, to evaluate associations between occupancy rate and turnaround time.

Results: Between January 2010 and December 2010, 163,659 patients transported to 28 EDs were enrolled. The median occupancy rate was 0.42 (range: 0.10-1.94; interquartile range (IQR): 0.20-0.76). Overcrowded EDs were more likely to have older patients, those with normal mentality, and non-trauma patients. Overcrowded EDs were more likely to have longer turnaround intervals and traveling distances. The MLM analysis showed that an increase of 1% in occupancy rate was associated with 0.02-minute decrease in turnaround interval (95% CI: 0.01 to 0.03). In subgroup analyses limited to EDs with occupancy rates over 100%, we also observed a 0.03 minute decrease in turnaround interval per 1% increase in occupancy rate (95% CI: 0.01 to 0.05).

Conclusions: In this study, we found wide variation in emergency department crowding in a metropolitan Korean city. Our data indicate that ED overcrowding is negatively associated with turnaround interval with very small practical significance.

No MeSH data available.


Related in: MedlinePlus