Emergency department enlargement in China: exciting or bothering

Xiong

The Journal of Emergency Medicine

et al. 2018

One principal reason for ED crowding in Beijing lies in the large numbers of patients who persist in the expectation of receiving ongoing care in the ED for minor illnesses. However, as is true in many nations, one of the other most important root causes of ED crowding is "access block," the inability to promptly move patients deemed by emergency physicians to need inpatient care to an inpatient bed for that care. However, in our system, another challenge, not widely described as a contributor to crowding in other nations, is that doctors assigned to inpatient services have been empowered to refuse to admit patients perceived to have overly "complex" needs. Further, patients with multisystem illnesses or end-stage status, who need ongoing chronic care to manage activities of daily living, have begun to populate Beijing EDs in increasing numbers. This is an issue with various root causes.

“…We believe this is the most recent study of the census and exit block status of teaching EDs in the city of Beijing (7)(8)(9). Emergency medicine is a young discipline in China.…”

Section: Discussionmentioning

confidence: 91%

Causes of Emergency Department Overcrowding and Blockage of Access to Critical Services in Beijing: A 2-Year Study

Xiong

The Journal of Emergency Medicine

et al. 2018

“…Apart from this, there were other factors aggravating ED volume. For example, ignore of preventive care; ED required insisting on primary responsibility; insufficient medical service provided by basic general hospitals as well as no threshold restriction in ED [6,15,17].…”

Section: Discussionmentioning

confidence: 99%

Hospitalization Rates Difference of Adult Emergency Patients between Urban and Suburban in Tianjin

Wang¹

2018

Immunome Res

Aim: Compare the hospitalization rate of adult emergency patients within 6 h of arrival between urban and suburban hospitals in Tianjin. Method: We analyzed a cross-sectional survey data for adult emergency patients. Fifty hospitals were divided into two groups: urban and suburban group according to geographical location. Each group was classified into two (secondary and tertiary hospital) subgroups. The emergency hospitalization rate within 6 h of arrival, gender and age of patients, Emergency Severity Index (ESI), as well as the mode of arrival and primary diagnosis, were collected and compared using Student's t-test, χ2 test, or Fisher's exact test as appropriate between both groups and subgroups. Results: 1) 6569 patients visited emergency departments and 494 (7.52%) were hospitalized within 6 h of arrival. 178 of 3680 (4.84%) and 316 of 2889 (10.94%) patients were hospitalized in the urban and suburban group, there was a significant difference between two groups (P <0.05). 2) Concerning tertiary subgroup, 157 of 2984 (5.26%) urban and 253 of 1833 (13.80%) suburban patients were hospitalized; in secondary subgroup, 21 of 696 (3.02%) urban and 63 of 1056 (5.97%) suburban patients were hospitalized, there were a significant difference between both two subgroups (P<0.05). 3) There was a significant difference in age, yet no significant difference in other aspects. 4) Injury patients in suburban hospitals were more than urban hospitals while pregnancy/childbirth patients were converse (P<0.05). Conclusions: Adult emergency patients' hospitalization rate was 7.52% in Tianjin and suburban tertiary hospitals possess the relatively higher hospitalization rate.

“…Overcrowding is a serious problem in developed countries (1)(2)(3)(4)17) and in China (5) and is primarily due to the large number of emergency visitors, shortage of emergency departments (EDs), nurses, and physicians, and limited access to health services. Overcrowding can lead to poor patient outcomes and increased length of stay (17).…”

Section: Introductionmentioning

confidence: 99%

Emergency Overcrowding is Seasonal in a Hospital in Hainan Province, Southern China

Jiao

Yong-hong

et al. 2020

Preprint

Background Emergency overcrowding is a serious problem for hospital staff in China. Immigrant patients caused emergency overcrowding in a hospital in southern China. However, the demographic characteristics of this population have not been determined. Methods Data on all emergency visitors, including patients who stayed in emergency department (ED) observation units or critical care units were collected and saved in an Excel sheet. Patient characteristics, including place of origin, type of disease, visiting time, and factors associated with prolonged stay in the ED, were analyzed. Results There were 141,024 emergency visitors in a 5-year interval, and only 24.0% of them were local residents. The number of patients was higher from November to March of next year. Immigrant patients usually had more commodity diseases than local residents. A total of 3,173 patients stayed in the ED observation unit or critical care unit in one-year interval. The number of patients in the ED and their LOS were higher from November 2017 to March 2018. Conclusions Emergency overcrowding in a hospital in southern China was seasonal and was caused by an increasing number of immigrants. Several patients stayed in the ED for a long time, especially those with special commodity diseases. Hospitals and the government should take measures to address the problems related to emergency overcrowding. Key words: Emergency overcrowding; Immigrant patients; Southern China