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KMID : 0385920140250060722
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Journal of the Korean Society of Emergency Medicine
2014 Volume.25 No. 6 p.722 ~ p.729
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Mid-Term Effects of Tertiary Hospital Beds Expansion on Emergency Department Overcrowding
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Kim Ki-Wook
Kim Soo-Hyun
Park Kyu-Nam
Kim Han-Joon
Oh Sang-Hoon
Lee Ju-Young
Lee Jung-Min
Lim Jee-Yong
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Abstract
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Purpose: Emergency department (ED) overcrowding isrecognized as a major concern not only because it is associatedwith patient dissatisfaction, but also because itimpinges on quality of care. The goal of this study is to evaluatethe mid-term effects of hospital bed capacity expansionon overcrowding in the emergency department for twoyears.
Methods: This was a pre-post study conducted usingadministrative data from the ED. On May 1st, 2011, the hospitallicensed beds were expanded from 1150 to 1300. Datafrom one year of the pre-expansion period (May 1st, 2010 toApril 30th, 2011) and two years of post-expansion weredivided into two periods; early period and late period wereincluded for this analysis. In these periods, we calculatedthe National Emergency Department Overcrowding Scale(NEDOCS) and occupancy rate at the same time of everyday. The main outcomes included length of stay (LOS) inthe ED and NEDOCS.
Results: A total of 177,766 patients were included. Themean 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 holdpatients, age, number of admission patients and operatingrate of hospital beds showed association with mean EDLOS (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 inresolving ED overcrowding for at least two years.
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KEYWORD
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Emergency service, Hospital, Crowding, Bed occupancy, Tertiary care centers
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