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
. 2021 Feb 17;16(2):e0247042.
doi: 10.1371/journal.pone.0247042. eCollection 2021.

The effect of overcrowding in emergency departments on the admission rate according to the emergency triage level

Hae Min Jung  1 , Min Joung Kim  1 , Ji Hoon Kim  1 , Yoo Seok Park  1 , Hyun Soo Chung  1 , Sung Phil Chung  1 , Ji Hwan Lee  1
Affiliations

The effect of overcrowding in emergency departments on the admission rate according to the emergency triage level

Hae Min Jung et al. PLoS One. .

Abstract

Overcrowding in emergency departments is a serious public health issue. Recent studies have reported that overcrowding in emergency departments affects not only the quality of emergency care but also clinical decisions about admission. However, no studies have examined the characteristics of the patient groups whose admission rate is influenced by such overcrowding. This retrospective cohort study was conducted in a single emergency department between January 1 and December 31, 2018. Patients over 19 years old were enrolled and divided into three groups according to the degree of overcrowding-high, low, and non-based on the total number of patients in the emergency department. An emergency triage tool (the Korean Triage and Acuity Scale) was used, which categorizes patients into five different levels. We analyzed whether the degree of change in the admission rate according to the extent of overcrowding differed for each triage group. There were 73,776 patients in this study. In the analysis of all patient groups, the admission rate increased as the degree of overcrowding rose (the adjusted odds ratio for admission was 1.281 (1.225-1.339) in the high overcrowding group versus the non-overcrowding group). The analysis of the patients in each triage level showed an increase in the admission rate associated with the overcrowding, which was greater in the patient groups with a lower triage level (adjusted odds ratios for admission in the high overcrowding group versus non-overcrowding group: Korean Triage and Acuity Scale level 3 = 1.215 [1.120-1.317], level 4 = 1.294 [1.211-1.382], and level 5 = 1.954 [1.614-2.365]).

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Number of included patients.
ED, emergency department; NOG, non-overcrowding group; LOG, low overcrowding group; HOG, high overcrowding group.
Fig 2
Fig 2. Linear predictor for admission using the Korean Triage and Acuity Scale value.
KTAS, Korean Triage and Acuity Scale; ED, emergency department.
See this image and copyright information in PMC

References

    1. Canadian Association of Emergency Physicians and the National Emergency Nurses Affiliation. Access to acute care in the setting of emergency department overcrowding. Canadian Journal of Emergency Medicine. 2003;5(2):81–6. Epub 2015/05/21. 10.1017/s1481803500008204 - DOI - PubMed
    1. National Emergency Medical Center. Emergency Medical Statistical Yearbook 2018. [posted 2019 Aug 26; cited 2020 Oct 02]: [126p]. Available from: https://www.e-gen.or.kr/nemc/statistics_annual_report.do.
    1. Song YJ. The South Korean Health Care System. JMAJ. 2009;52:206–9.
    1. Hoot NR, Aronsky D. Systematic review of emergency department crowding: causes, effects, and solutions. Annals of emergency medicine. 2008;52(2):126–36. Epub 2008/04/25. 10.1016/j.annemergmed.2008.03.014 - DOI - PMC - PubMed
    1. Di Somma S, Paladino L, Vaughan L, Lalle I, Magrini L, Magnanti M. Overcrowding in emergency department: an international issue. Intern Emerg Med. 2015;10(2):171–5. Epub 2014/12/03. 10.1007/s11739-014-1154-8 - DOI - PubMed