Patients who were admitted on days with high emergency department crowding had .8% longer hospital stays and 1% increased costs per admission. Periods of high emergency department crowding were associated with 300 excess inpatient deaths, 6,200 hospital days and $17 million in costs, the study found.
"Our findings are robust," Sun says. "Every way we sliced the data it showed that the system is such that if you came into the hospital on a really busy day and you were admitted you had a higher rate of death than if you were admitted on a day when it wasn't so busy."
Although a trip the emergency room is not something that individual patients can pencil in, Sun says that hospitals should be able to track ebb and flow in their EDs.
"For most hospitals the number of patients who need to be admitted from the ED is a very predictable thing," he says. "What the profession has learned over the past 10 years of research is that ED crowding is driven by the availability of inpatient beds. When you say ‘ED crowding' it is a symptom of a problem somewhere else in the hospital."
"This is something that leaders in hospitals are increasingly aware of," he says. "Folks who run hospitals are trying to figure out how to reduce the boarding of admitted patients in the ED and how to improve the through-put of the patient in the inpatient side."