Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Influence of Overcrowding in the Emergency Department on Return Visit within 72 Hours

Version 1 : Received: 23 April 2020 / Approved: 25 April 2020 / Online: 25 April 2020 (10:45:25 CEST)

A peer-reviewed article of this Preprint also exists.

Kim, D.-U.; Park, Y.S.; Park, J.M.; Brown, N.J.; Chu, K.; Lee, J.H.; Kim, J.H.; Kim, M.J. Influence of Overcrowding in the Emergency Department on Return Visit within 72 Hours. J. Clin. Med. 2020, 9, 1406. Kim, D.-U.; Park, Y.S.; Park, J.M.; Brown, N.J.; Chu, K.; Lee, J.H.; Kim, J.H.; Kim, M.J. Influence of Overcrowding in the Emergency Department on Return Visit within 72 Hours. J. Clin. Med. 2020, 9, 1406.

Journal reference: J. Clin. Med. 2020, 9, 1406
DOI: 10.3390/jcm9051406

Abstract

This study was conducted to determine whether overcrowding in the emergency department (ED) affects the occurrence of a return visit (RV) within 72 hours. The crowding indicator of index visit was the average number of total patients, patients under observation, and boarding patients during the first 1 and 4 hours from ED arrival time and the last 1 hour before ED departure. Logistic regression analysis was conducted to determine whether each indicator affects the occurrence of RV and post-RV admission. Of the 87,360 discharged patients, 3,743 (4.3%) returned to the ED within 72 hours. Of the crowding indicators pertaining to total patients, the last 1 hour significantly affected decrease in RV (p=0.0046). Boarding patients were found to increase RV occurrence during the first 1 hour (p=0.0146) and 4 hours (p=0.0326). Crowding indicators that increased the likelihood of admission post-RV were total number of patients during the first 1 hour (p=0.0166) and 4 hours (p=0.0335) and evaluationg patients during the first 1 hour (p=0.0059). Overcrowding in the ED increased the incidence of RV and likelihood of post-RV admission. However, overcrowding at the time of ED departure was related to reduced RV.

Subject Areas

emergency department; crowding; return visit; admission; patient satisfaction; quality of healthcare

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