Increasing Length of Stay Among Adult Visits to U.S. Emergency Departments, 2001–2005

Herring, Andrew A.; Wilper, Andrew P.; Himmelstein, David U.; Woolhandler, Steffie; Espinola, Janice A.; Brown, David F.M.; Camargo, Carlos A.

doi:10.1111/j.1553-2712.2009.00428.x

Cited by 142 publications

(115 citation statements)

References 34 publications

(43 reference statements)

Supporting

Mentioning

104

Contrasting

Order By: Relevance

“…[22] Several studies have shown that language barriers not only increased the LOS in EDs, but also decreased patients' satisfaction. [3,13,14] Carrasquillo et al [13] reported that compared to English speakers, non-English speakers were less satisfi ed with the care they received in the ED as, were less willing to return to same ED if they had a problem which they felt required emergency care, and reported more problems with emergency care. Therefore, understanding why these patients are staying longer in the ED is an important factor in enhancing the acute care delivered to these patients in the EDs.…”

Section: Discussionmentioning

confidence: 99%

“…These findings agree with previous studies in other countries. [3,13,14] Public hospital EDs in Queensland see patients who have little or no understanding of English due to a high proportion of immigrants living in the state. Additional time is needed to obtain an interpreter, and even when an interpreter is readily available, the emergency physician requires additional time for this interaction.…”

Section: Discussionmentioning

confidence: 99%

“…[4,5] LOS can be associated with ED overcrowding, decreased patient satisfaction with ED care, ambulance diversion and poor clinical outcomes. [3,4] An association with a long LOS in the ED has also been found in differences in language between health care providers and patients. [6,7] In Australia, approximately 15.6% of the population speaks a language other than English at home, with approximately 3% having limited English profi ciency.…”

Section: Introductionmentioning

confidence: 99%

“…[1] Length of stay (LOS) is a marker of ED overcrowding and a key component of ED quality assurance monitoring. [2,3] ED LOS is usually defined as the time from a patient's registration until that patient's departure from the ED. [4,5] LOS can be associated with ED overcrowding, decreased patient satisfaction with ED care, ambulance diversion and poor clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Language affects length of stay in emergency departments in Queensland public hospitals

Mahmoud

Hou

Chu

et al. 2013

World Journal of Emergency Medicine

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Language affects length of stay in emergency departments in Queensland public hospitals

Mahmoud

Hou

Chu

et al. 2013

World Journal of Emergency Medicine

View full text Add to dashboard Cite

“…Our choices were limited to using rapid but analytically imprecise assays or more accurate but significantly slower laboratory platforms. Since it is currently agreed that the time delay of the slower tests is "just an hour or so difference" [1], the risk of patient morbidity and mortality increases with more time spent in the emergency department (ED) [2]. A Canadian study, which examined the association between waiting times and short-term mortality and hospital admission after departure from ED of more than 13 million ED patients, showed as a secondary result, that the odds of acute death increased dramatically (OR = 1.79) when the ED length of stay (LOS) exceeded 6 h compared with > 1 h [3].…”

Section: Introductionmentioning

confidence: 99%

Opinion paper on utility of point-of-care biomarkers in the emergency department pathways decision making

Somma

Zampini

Vetrone

et al. 2014

Clinical Chemistry and Laboratory Medicine (CCLM)

View full text Add to dashboard Cite

Abstract:Overcrowding of the emergency department (ED) is rapidly becoming a global challenge and a major source of concern for emergency physicians. The evaluation of cardiac biomarkers is critical for confirming diagnoses and expediting treatment decisions to reduce overcrowding, however, physicians currently face the dilemma of choosing between slow and accurate central-based laboratory tests, or faster but imprecise assays. With improvements in technology, point-of-care testing (POCT) systems facilitate the efficient and high-throughput evaluation of biomarkers, such as troponin (cTn), brain natriuretic peptide (BNP) and neutrophil gelatinase-associated lipocalin (NGAL). In this context, POCT may help ED physicians to confirm a diagnosis of conditions, such as acute coronary syndrome, heart failure or kidney damage. Compared with classic laboratory methods, the use of cTn, BNP, and NGAL POCT has shown comparable sensitivity, specificity and failure rate, but with the potential to provide prompt and accurate diagnosis, shorten hospital stay, and alleviate the burden on the ED. Despite this potential, the full advantages of rapid delivery results will only be reached if POCT is implemented within hospital standardized procedures and ED staff receive appropriate training.

show abstract

Percentage of US Emergency Department Patients Seen Within the Recommended Triage Time

Horwitz

Bradley²

2009

Arch Intern Med

View full text Add to dashboard Cite

Background The wait time to see a physician in US emergency departments (EDs) is increasing and may differentially affect patients with varied insurance status and racial/ethnic backgrounds. Methods Using a stratified random sampling of 151 999 visits, representing 539 million ED visits from 1997 to 2006, we examined trends in the percentage of patients seen within the triage target time by triage category (emergent, urgent, semiurgent, and nonurgent), payer type, and race/ethnicity. Results The percentage of patients seen within the triage target time declined a mean of 0.8% per year, from 80.0% in 1997 to 75.9% in 2006 (P<.001). The percentage of patients seen within the triage target time declined 2.3% per year for emergent patients (59.2% to 48.0%; P<.001) compared with 0.7% per year for semiurgent patients (90.6% to 84.7%; P<.001). In 2006, the adjusted odds of being seen within the triage target time were 30% lower than in 1997 (odds ratio, 0.70; 95% confidence interval, 0.55-0.89). The adjusted odds of being seen within the triage target time were 87% lower (odds ratio, 0.13; 95% confidence interval, 0.11-0.15) for emergent patients compared with semiurgent patients. Patients of each payment type experienced similar decreases in the percentage seen within the triage target over time (P for interaction=.24), as did patients of each racial/ethnic group (P=.05). Conclusions The percentage of patients in the ED who are seen by a physician within the time recommended at triage has been steadily declining and is at its lowest point in at least 10 years. Of all patients in the ED, the most emergent are the least likely to be seen within the triage target time. Patients of all racial/ethnic backgrounds and payer types have been similarly affected.

show abstract

Increasing Length of Stay Among Adult Visits to U.S. Emergency Departments, 2001–2005

Cited by 142 publications

References 34 publications

Language affects length of stay in emergency departments in Queensland public hospitals

Language affects length of stay in emergency departments in Queensland public hospitals

Opinion paper on utility of point-of-care biomarkers in the emergency department pathways decision making

Percentage of US Emergency Department Patients Seen Within the Recommended Triage Time

Contact Info

Product

Resources

About