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Review
. 2023 Jan 29;11(3):385.
doi: 10.3390/healthcare11030385.

The Association between Emergency Department Overcrowding and Delay in Treatment: A Systematic Review

Adel Darraj  1 , Ali Hudays  2 , Ahmed Hazazi  3 , Amal Hobani  1 , Alya Alghamdi  2
Affiliations
Review

The Association between Emergency Department Overcrowding and Delay in Treatment: A Systematic Review

Adel Darraj et al. Healthcare (Basel). .

Abstract

Emergency department (ED) overcrowding is a global health issue that is associated with poor quality of care and affects the timeliness of treatment initiation. The purpose of this systematic review is to assess the association between overcrowding and delay in treatment. A systematic review was conducted using four databases (CINAHL, PubMed, Scopus, Cochrane Library), following the preferred reporting items for systematic reviews and meta-analysis (PRISMA). A structured search was conducted to identify peer-reviewed articles aimed at assessing the relationship between overcrowding and delay in treatment, published between January 2000 and January 2021. Only studies that were conducted in the ED settings were included, and that includes both triage and observation rooms. The studies were appraised using two quality appraisal tools including the critical appraisal skills programme (CASP) for cohort studies and the Joanna Briggs Institute (JBI) checklist tool for cross-sectional studies. A total of 567 studies screened, and 10 met the inclusion criteria. Of these studies, 8 were cohorts and 2 were cross-sectionals. The majority reported that overcrowding is associated with a delay in the initiation of antibiotics for patients with sepsis and pneumonia. The review identified that overcrowding might impact time-to-treatment and, thus, the quality of care delivered to the patient. However, further research aimed at finding feasible solutions to overcrowding is encouraged.

Keywords: accidents and emergency; crowding; delay in treatment; emergency department; overcrowding; time-to-treatment.

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Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Morganti K.G., Bauhoff S., Blanchard J.C., Abir M., Iyer N., Smith A., Vesely J.V., Okeke E.N., Kellermann A.L. The Evolving Role of Emergency Departments in the United States. Rand Health Q. 2013;3:3. - PMC - PubMed
    1. Australian Institute of Health and Welfare . Emergency Department Care 2017–2018: Australian Hospital Statistics. AIHW; Canberra, Australia: 2018. (Health Services Series no. 89. Cat. no. HSE 216).
    1. Cairns C., Ashman J.J., Kang K. Emergency Department Visit Rates by Selected Characteristics: United States, 2018. CDC; Atlanta, GA, USA: 2021. pp. 1–8. NCHS Data Brief. 401. - PubMed
    1. Ward M.J., Ferrand Y.B., Laker L.F., Froehle C.M., Vogus T.J., Dittus R.S., Kripalani S., Pines J.M. The Nature and Necessity of Operational Flexibility in the Emergency Department. Ann. Emerg. Med. 2015;65:156–161. doi: 10.1016/j.annemergmed.2014.08.014. - DOI - PMC - PubMed
    1. Hoot N.R., Aronsky D. Systematic Review of Emergency Department Crowding: Causes, Effects, and Solutions. Ann. Emerg. Med. 2008;52:126–136. doi: 10.1016/j.annemergmed.2008.03.014. - DOI - PMC - PubMed

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