Association Between Emergency Department Overcrowding and Patient Outcome at a Teaching Hospital, at Eastern Province in Saudi Arabia

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Saudi Digital Library
Abstract
An emergency department (ED) is highly important in a hospital setting, given that it offers 24-hour professional healthcare to patients in need. However, ED overcrowding has started to be a global healthcare crisis, where the patient capacity of an ED is not high enough to meet the demands of its patient. Thus, this study aimed to explore the possible relationships between ED crowding and both mortality rates and length of stay in an ED.Methods: This retrospective cohort analysis used data abstracted from the Quadra Med Information System on patients who visited the ED of a tertiary university hospital in the Eastern province of Saudi Arabia during the period from 1 January 2018 to 31 December 2018. The criteria for ED occupancy rates were: low crowded if the ED occupancy was ≤ 0.50 the occupancy rate and as high crowded if the ED occupancy was ≥ 1.00 the occupancy rates. Length of stay was defined as prolonged when is more than six hours.Result: Our results showed that there was no significant association between mortality rates and crowding status in the ED. On the other hand, the median length ± interquartile range of the length of stay for low-crowded and high-crowded conditions were 211 ± 606 and 242 ± 659 minutes, respectively. There was a significant association between ED crowding status and length of stay (p < .05).Conclusions: Crowding status was not associated with increased mortality. However, patients’ length of stay in the ED was associated with the crowding status of ED. Therefore, decision-makers at the ministry of health should develop and implement measures to shed light on the causes of overcrowding in the ED and interventions to reduce such crowding and resolve the problems that follow from such conditions to shorten the patients’ length of stay in the ED.
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