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Am J Emerg Med. 2012 Nov;30(9):1884-94. doi: 10.1016/j.ajem.2012.04.001. Epub 2012 Jul 12.

Patterns and factors associated with intensive use of ED services: implications for allocating resources.

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  • 1Yale School of Public Health, Health Policy and Administration, New Haven, CT 06520, USA. jennifer.ruger@yale.edu

Abstract

AIM:

This study aims to better understand the patterns and factors associated with the use of emergency department (ED) services on high-volume and intensive (defined by high volume and high-patient severity) days to improve resource allocation and reduce ED overcrowding.

METHODS:

This study created a new index of "intensive use" based on the volume and severity of illness and a 3-part categorization (normal volume, high volume, intensive use) to measure stress in the ED environment. This retrospective, cross-sectional study collected data from hospital clinical and financial records of all patients seen in 2001 at an urban academic hospital ED.

RESULTS:

Multiple logistic regression models identified factors associated with high volume and intensive use. Factors associated with intensive days included being in a motor vehicle crash; having a gun or stab wound; arriving during the months of January, April, May, or August; and arriving during the days of Monday, Tuesday, or Wednesday. Factors associated with high-volume days included falling from 0 to 10 ft; being in a motor vehicle crash; arriving during the months of January, April, May, or August; and arriving during the days of Monday, Tuesday, or Wednesday.

CONCLUSION:

These findings offer inputs for reallocating resources and altering staffing models to more efficiently provide high-quality ED services and prevent overcrowding.

Copyright © 2012 Elsevier Inc. All rights reserved.

PMID:
22795412
[PubMed - indexed for MEDLINE]
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