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Emergency short-stay wards and boarding time in emergency departments: A propensity-score matching study

Authors
 Min Ok  ;  Arom Choi  ;  Min Joung Kim  ;  Yun Ho Roh  ;  Incheol Park  ;  Sung Phil Chung  ;  Ji Hoon Kim 
Citation
 AMERICAN JOURNAL OF EMERGENCY MEDICINE, Vol.38(12) : 2495-2499, 2020-12 
Journal Title
 AMERICAN JOURNAL OF EMERGENCY MEDICINE 
ISSN
 0735-6757 
Issue Date
2020-12
Keywords
Emergency department ; Emergency short-stay ward ; Hospital bed saturation ; Hospitalization ; In-hospital mortality ; Intensive care unit
Abstract
Objectives: This study aimed to validate the effectiveness of an emergency short-stay ward (ESSW) and its impact on clinical outcomes. Methods: This retrospective observational study was performed at an urban tertiary hospital. An ESSW has been operating in this hospital since September 2017 to reduce emergency department (ED) boarding time and only targets patients indicated for admission to the general ward from the ED. Propensity-score matching was performed for comparison with the control group. The primary outcome was ED boarding time, and the secondary outcomes were subsequent intensive care unit (ICU) admission and 30-day in-hospital mortality. Results: A total of 7461 patients were enrolled in the study; of them, 1523 patients (20.4%) were admitted to the ESSW. After propensity-score matching, there was no significant difference in the ED boarding time between the ESSW group and the control group (P = 0.237). Subsequent ICU admission was significantly less common in the ESSW group than in the control group (P < 0.001). However, the 30-day in-hospital mortality rate did not differ significantly between the two groups (P = 0.292). When the overall hospital bed occupancy ranged from 90% to 95%, the proportion of hospitalization was the highest in the ESSW group (29%). An interaction effect test using a general linear model confirmed that the ESSW served as an effect modifier with respect to bed occupancy and boarding time (P < 0.001). Conclusion: An ESSW can alleviate prolonged boarding time observed with hospital bed saturation. Moreover, the ESSW is associated with a low rate of subsequent ICU admission.
Full Text
https://www.sciencedirect.com/science/article/pii/S0735675719308071
DOI
10.1016/j.ajem.2019.12.014
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Joung(김민정) ORCID logo https://orcid.org/0000-0003-1634-5209
Kim, Ji Hoon(김지훈) ORCID logo https://orcid.org/0000-0002-0070-9568
Roh, Yun Ho(노윤호)
Park, In Cheol(박인철) ORCID logo https://orcid.org/0000-0001-7033-766X
Chung, Sung Phil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/181385
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