Emergency Department Overcrowding

McCabe, John B.

doi:10.1097/00001888-200107000-00005

Cited by 78 publications

(50 citation statements)

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“…Its services are provided regardless of economic or social status and without an appointment. Accident and Emergency Department (AED) overcrowding has been an increasingly serious health problem for more than a decade 2,3 . The inability of the Nigeria's emergency departments to meet current demands is growing among the public and health care professionals.…”

Section: Introductionmentioning

confidence: 99%

“…The resulting phenomenon, commonly referred to as AED overcrowding, now threatens access to emergency services for those who need them the most 4,5 . AED overcrowding is a clear, almost inevitable indicator of steadily growing demand that has exceeded available resources 3 . Surprisingly, this saturation of emergency services is not usually a result of excessive, inappropriate use of the AED by those with nonemergent problems.…”

Section: Introductionmentioning

confidence: 99%

“…Surprisingly, this saturation of emergency services is not usually a result of excessive, inappropriate use of the AED by those with nonemergent problems. It is a byproduct of increasing numbers of patients with serious illnesses or injuries requiring hospital and/or intensive care unit admission [2][3][4][5] . AED overcrowding is an increasingly difficult impediment to access emergency care, causing loss of patient privacy and confidentiality, delays in receiving care and time sensitive treatments, patient departure prior to the completion of care and staff and patient dissatisfaction 5 .…”

Section: Introductionmentioning

confidence: 99%

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Overcrowding of accident & emergency units: is it a growing concern in Nigeria?

Makama¹,

Iribhogbe²,

Ameh³

2015

Afr H. Sci.

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Background: The inability of the Nigeria's Accident and Emergency Departments (AED) to meet current demands is growing among the public and health care professionals. The data supporting perceptions of insufficient capacity are limited. Therefore, this study was intended to determine the prevalence, causes, and effects of overcrowding AEDs in Nigeria. Materials and Methods: This was a cross sectional, descriptive study carried out among AED staff of 3 referral teaching hospitals in Nigeria, using a pre-tested and validated structured questionnaire. Results: The analysis of the 267 AED staff revealed 20-56years (36.40+5.1 mean) age range. One hundred and twenty eight (47.9%) were males, 139 (52.1%) females. Two hundred and fifty nine (97%) agreed that an AED should have a bed capacity of 21-30. Agreement to AED overcrowding in Nigeria was quite considerable. The frequency of AED overcrowding per week was 4-7 times. The average bed occupancy level was 3.25. Agreed common causes of prolonged AED admissions were to be a high volume of critically ill patients, Delayed transfer of patients to the wards, delay in theatre operation, delay in radiological investigations and exceptionally high proportion of patients requiring admission in AED. Also, long pre-review waiting time and haematological delays were more causes. The average waiting time for victims to be seen was 29.7minutes. Conclusion: There are many causes of AED overcrowding in this environment. However, improving AED bed management, better organized and diligent discharge planning, and reducing access block should be a priority to reduce AED overcrowding

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Overcrowding of accident & emergency units: is it a growing concern in Nigeria?

Makama¹,

Iribhogbe²,

Ameh³

2015

Afr H. Sci.

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“…3 This poses challenges for the health care system since EDs across the country have reported problems with overcrowding, diverting, and loss of beds. [4][5][6] The causes as well as the prevention of overcrowding in EDs are complex problems. 4 Perhaps one method of reducing ED overcrowding is to better identify and manage patients who frequently use the ED.…”

mentioning

confidence: 99%

Repeat Patients to the Emergency Department in a Statewide Database

et al. 2004

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Objectives: To describe the epidemiology of repeat users of the emergency department (ED) using a statewide database. Methods: Probabilistic linkage was used to convert three years of statewide ED visit data into a longitudinal, patientbased data set. Patients were classified as single, repeat (at least two visits within three years), or serial (four or more visits within a 365-day period) users of the ED. Serial patients were further stratified by the number of EDs attended. Descriptive statistics were used to assess differences between patient types. Results: There were 1,370,607 separate visits associated with 780,074 patients from 1996 to 1998. While repeat and serial patients represented 33% of the patients, they accounted for 62% of the ED visits during the study period. Repeat and serial patients were younger and had smaller median ED charges per visit than singleuse patients. Serial patients attending five or more EDs were more likely to be coded as self-pay than other serial patients. Diagnosis codes relating to sprains, back problems, and headaches were prevalent among serial patients who visited five or more EDs. Approximately 30% of serial patients during the first year remained serial patients in the second year. Conclusions: Due to the high turnover in serial patients, control groups in future studies are necessary to evaluate interventions aimed at decreasing serial ED use. The likelihood of serial ED users to use multiple EDs indicates that those studying serial ED use should collect data from multiple EDs.

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“…7 Other studies have also shown that emergency units often treat patients who can be treated at primary care centres. 5,8,9 Based on the above it would appear that long waiting times and expenditure at emergency units in South Africa could probably be reduced if non-critical patients presenting to an emergency unit could be referred to primary health care facilities.…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional profile and outcome assessment of adult patients triaged away from Steve Biko Academic Hospital emergency unit

Engelbrecht

Toit

Geyser

2015

South African Family Practice

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Background:Overcrowding is a global problem in emergency medicine. This study examined an approach to this problem at a central hospital. Methods: A prospective observational study was done to provide a cross-sectional profile of patients triaged away from the emergency unit (EU) and to evaluate their outcome by telephonic survey. Results: 549 patients were triaged away during the study period. There was no significant difference in the number of male and female patients in the sample. Female patients were significantly younger than males (p = 0.0399). The most common complaint was abdominal pain followed by extremity complaints. Females complained more of abdominal pains (OR 1.87, 95% CI [1.13-3.12]; p 0.0094), and males had more extremity complaints (OR 2.42, 95% CI [1.45-4.09]; p = 0.0003). Only 42 patients were available for telephonic follow-up; 66% of them received care on the same day at another treatment facility. No patients who were available for follow-up had died due to their presenting complaint or needed to be referred back. Conclusions:The typical patient triaged away was a 40-year-old female from the hospital's referral area with abdominal pain. This study indicated that the method of triage may be safe to determine which patients can be diverted from a central hospital to a lower level of care. There were various limitations to this study; hence, the findings of this study should be interpreted with caution.

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Emergency Department Overcrowding

Cited by 78 publications

References 0 publications

Overcrowding of accident & emergency units: is it a growing concern in Nigeria?

Overcrowding of accident & emergency units: is it a growing concern in Nigeria?

Repeat Patients to the Emergency Department in a Statewide Database

A cross-sectional profile and outcome assessment of adult patients triaged away from Steve Biko Academic Hospital emergency unit

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