J Korean Soc Emerg Med.  2014 Dec;25(6):722-729. 10.0000/jksem.2014.25.6.722.

Mid-Term Effects of Tertiary Hospital Beds Expansion on Emergency Department Overcrowding

• Kim KW
• Kim SH
• Park KN
• Kim HJ
• Oh SH
• Lee JY
• Lee JM
• Im JY

• KMID: 2101250
• DOI: http://doi.org/10.0000/jksem.2014.25.6.722

Abstract

PURPOSE
Emergency department (ED) overcrowding is recognized as a major concern not only because it is associated with patient dissatisfaction, but also because it impinges on quality of care. The goal of this study is to evaluate the mid-term effects of hospital bed capacity expansion on overcrowding in the emergency department for two years.
METHODS
This was a pre-post study conducted using administrative data from the ED. On May 1st, 2011, the hospital licensed beds were expanded from 1150 to 1300. Data from one year of the pre-expansion period (May 1st, 2010 to April 30th, 2011) and two years of post-expansion were divided into two periods; early period and late period were included for this analysis. In these periods, we calculated the National Emergency Department Overcrowding Scale (NEDOCS) and occupancy rate at the same time of every day. The main outcomes included length of stay (LOS) in the ED and NEDOCS.
RESULTS
A total of 177,766 patients were included. The mean number of daily ED patients was increased; 156.3+/-32.5 in the pre-expansion period, 162.5+/-32.5 and 167.9+/-32.4 in the early and late post-expansion periods, respectively (p<0.001). In multivariate linear regression analysis, hospital bed expansion, the number of admission hold patients, age, number of admission patients and operating rate of hospital beds showed association with mean ED LOS (coefficient=-82.9, 2.7, 6.4, 11.4 and 5.4 respectively, R2=0.628, p<0.001).
CONCLUSION
Expansion of hospital beds could be helpful in resolving ED overcrowding for at least two years.

Keyword

Emergency service; Hospital; Crowding; Bed occupancy; Tertiary care centers

MeSH Terms

Bed Occupancy
Crowding
Emergency Service, Hospital*
Hospital Bed Capacity
Humans
Length of Stay
Linear Models
Tertiary Care Centers*