J Korean Med Sci.  2017 Dec;32(12):1917-1920. 10.3346/jkms.2017.32.12.1917.

An Acute Medical Unit in a Korean Tertiary Care Hospital Reduces the Length of Stay and Waiting Time in the Emergency Department

• Ohn JH
• Kim NH
• Kim ES
• Baek SH
• Lim Y
• Hur J
• Lee YJ
• Kim ES
• Jang HC

• KMID: 2396366
• DOI: http://doi.org/10.3346/jkms.2017.32.12.1917

Abstract

A hospitalist-run acute medical unit (AMU) opened at a tertiary care hospital on August 2015 for the first time in Korea. Patients visiting the emergency department (ED) with acute medical problems are admitted to the AMU. They stay in that unit for less than 72 hours and are discharged or transferred to specialty wards if longer treatment is necessary. We reviewed 19,450 medical admissions through the ED from January 2014 to September 2016. The median length of stay (LOS) significantly decreased from 10.0 days (interquartile range [IQR], 5.5-16.7) to 9.1 days (IQR, 5.1-15.0) (P < 0.001) after the establishment of the AMU. The median waiting time in the ED significantly shortened by 40% (P < 0.001). Future studies on the impact of AMU on in-patient morbidity, mortality, re-admission rate, and patient or staff satisfaction are necessary.

Keyword

Hospital Medicine; Length of Stay; Hospitalists; Emergency Service, Hospital

MeSH Terms

Emergencies*
Emergency Service, Hospital*
Hospital Medicine
Hospitalists
Humans
Korea
Length of Stay*
Mortality
Tertiary Healthcare*

Figure

• 

  Fig. 1 The quarterly change in the median LOS and the number of admissions to internal medicine wards through the ED. The number in each bar indicates the median LOS in each quarter before (red bars) and after (dark red bars) the introduction of the AMU. With a reduction in the LOS, there was a concomitant rise in the number of admissions to the internal medicine wards through the ED (blue line and right axis).LOS = length of stay, ED = emergency department, AMU = acute medical unit.

• 

  Fig. 2 The median waiting time in the ED before admission to internal medicine wards. After the AMU was introduced in August 2015, the waiting time decreased from 17.1 (IQR, 8.4–30.6) to 10.2 (IQR, 5.9–16.3) hours (by 40%), which persisted to September 2016.ED = emergency department, AMU = acute medical unit, IQR = interquartile range.

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