Patients admitted to the hospital from the emergency department during periods of high crowding died more often than similar patients admitted to the same hospital when the ED was less crowded, according to a study published in the Annals of Emergency Medicine. Crowding also was associated with longer lengths of stay and increased costs.
Researchers analyzed nearly 1 million ED visits resulting in admissions to 187 California hospitals. Daily ambulance diversion (closing an ED to ambulances because it is too crowded to accept new patients) was the measure of crowding. Admission from the ED on days with prolonged diversion (a median of 7 hours) — or high ED crowding — was associated with 5 percent increased odds of dying in the hospital compared with admissions on days with low ambulance diversion (a median of 0 hours).
Patients admitted on days with high ED crowding had 0.8 percent longer hospital stays and 1 percent increased costs per admission. These periods were associated with 300 excess inpatient deaths, 6,200 hospital days and $17 million in costs.
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