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
. 2016 Aug;31(8):1331-6.
doi: 10.3346/jkms.2016.31.8.1331. Epub 2016 May 18.

Emergency Department Crowding Disparity: a Nationwide Cross-Sectional Study

Won Chul Cha  1 , Ki Ok Ahn  2 , Sang Do Shin  2 , Jeong Ho Park  3 , Jin Sung Cho  4
Affiliations

Emergency Department Crowding Disparity: a Nationwide Cross-Sectional Study

Won Chul Cha et al. J Korean Med Sci. 2016 Aug.

Abstract

In this study, we evaluated national differences in emergency department (ED) crowding to identify factors significantly associated with crowding in institutes and communities across Korea. This was a cross-sectional nationwide observational study using data abstracted from the National Emergency Department Information System (NEDIS). We calculated mean occupancy rates to quantify ED crowding status and divided EDs into three groups according to their occupancy rates (cutoffs: 0.5 and 1.0). Factors potentially related to ED crowding were collected from the NEDIS. We performed a multivariate regression analysis to identify variables significantly associated with ED crowding. A total of 120 EDs were included in the final analysis. Of these, 73 were categorized as 'low crowded' (LC, occupancy rate < 0.50), 37 as 'middle crowded' (MC, 0.50 ≤ occupancy rate < 1.00), 10 EDs as 'high crowded' (HC, 1.00 ≤ occupancy rate). The mean ED occupancy rate varied widely, from 0.06 to 2.33. The median value was 0.39 with interquartile ranges (IQRs) from 0.20 to 0.71. Multivariate analysis revealed that after adjustment, ED crowding was significantly associated with the number of visits, percentage of patients referred, number of nurses, and ED disposition. This nationwide study observed significant variety in ED crowding. Several input, throughput, and output factors were associated with crowding.

Keywords: Crowding; Emergency Service; Hospital; National Health Program.

PubMed Disclaimer

Conflict of interest statement

DISCLOSURE: All authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Selection of study hospitals. Overall, 120 nation-wide Emergency centers were included.
Fig. 2
Fig. 2
Average ED bed occupancy rate. The median was 0.39 with inter-quartile range 0.20–0.71.
Fig. 3
Fig. 3
Locations of enrolled emergency departments. Note that high crowd emergency departments are co-located among low crowd emergency departments. Many overcrowded EDs are located in Metropolitan area, especially in Seoul.
See this image and copyright information in PMC

References

    1. Institute of Medicine Committee on the Future of Emergency Care in the United States Health System (US) Hospital-Based Emergency Care: at the Breaking Point. Washington, D.C.: National Academies Press; 2007.
    1. Sun BC, Binstadt ES, Pelletier A, Camargo CA., Jr Characteristics and temporal trends of “left before being seen” visits in US emergency departments, 1995-2002. J Emerg Med. 2007;32:211–215. - PubMed
    1. Asaro PV, Lewis LM, Boxerman SB. Emergency department overcrowding: analysis of the factors of renege rate. Acad Emerg Med. 2007;14:157–162. - PubMed
    1. Pines JM, Localio AR, Hollander JE, Baxt WG, Lee H, Phillips C, Metlay JP. The impact of emergency department crowding measures on time to antibiotics for patients with community-acquired pneumonia. Ann Emerg Med. 2007;50:510–516. - PubMed
    1. Pines JM, Hollander JE. Emergency department crowding is associated with poor care for patients with severe pain. Ann Emerg Med. 2008;51:1–5. - PubMed