Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Oct 13;9(10):e108447.
doi: 10.1371/journal.pone.0108447. eCollection 2014.

Execution of diagnostic testing has a stronger effect on emergency department crowding than other common factors: a cross-sectional study

Takahisa Kawano  1 , Kei Nishiyama  2 , Hiroyuki Hayashi  3
Affiliations

Execution of diagnostic testing has a stronger effect on emergency department crowding than other common factors: a cross-sectional study

Takahisa Kawano et al. PLoS One. .

Abstract

Study objective: We compared the effects of execution of diagnostic tests in the emergency department (ED) and other common factors on the length of ED stay to identify those with the greatest impacts on ED crowding.

Methods: Between February 2010 and January 2012, we conducted a cross-sectional, single-center study in the ED of a large, urban, teaching hospital in Japan. Patients who visited the ED during the study period were enrolled. We excluded (1) patients scheduled for admission or pharmaceutical prescription, and (2) neonates requiring intensive care transferred from other hospitals. Multivariate linear regression was performed on log-transformed length of ED stay in admitted and discharged patients to compare influence of diagnostic tests and other common predictors. To quantify the range of change in length of ED stay given a unit change of the predictor, a generalized linear model was used for each group.

Results: During the study period, 55,285 patients were enrolled. In discharged patients, laboratory blood tests had the highest standardized β coefficient (0.44) among common predictors, and increased length of ED stay by 72.5 minutes (95% CI, 72.8-76.1 minutes). In admitted patients, computed tomography (CT) had the highest standardized β coefficient (0.17), and increased length of ED stay by 32.7 minutes (95% CI, 40.0-49.9 minutes). Although other common input and output factors were significant contributors, they had smaller standardized β coefficients in both groups.

Conclusions: Execution of laboratory blood tests and CT had a stronger influence on length of ED stay than other common input and output factors.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Patient flow diagram. ED, emergency department.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Ministry of Internal Affairs and Communications (2010) Reserch of the acceptance of ambulance in the medical institution in 2009 (Japanese). Available: http://www.fdma.go.jp/neuter/topics/houdou/h22/2203/220318_6houdou.pdf. Accessed July 13 2013.
    1. Sun BC, Hsia RY, Weiss RE, Zingmond D, Liang LJ, et al. (2013) Effect of emergency department crowding on outcomes of admitted patients. Ann Emerg Med 61: 605–611 e606. - PMC - PubMed
    1. Kocher KE, Meurer WJ, Desmond JS, Nallamothu BK (2012) Effect of testing and treatment on emergency department length of stay using a national database. Acad Emerg Med 19: 525–534. - PubMed
    1. Oredsson S, Jonsson H, Rognes J, Lind L, Goransson KE, et al. (2011) A systematic review of triage-related interventions to improve patient flow in emergency departments. Scand J Trauma Resusc Emerg Med 19: 43. - PMC - PubMed
    1. Fatovich DM, Hirsch RL (2003) Entry overload, emergency department overcrowding, and ambulance bypass. Emerg Med J 20: 406–409. - PMC - PubMed

Publication types