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. 2023 May 12;23(1):47.
doi: 10.1186/s12873-023-00813-x.

Effect of emergency physician-operated emergency short-stay ward on emergency department stay length and clinical outcomes: a case-control study

Sean Moon  1 , Taegyun Kim  2   3   4   5 , Heesu Park  6 , Hayoung Kim  1 , Jieun Shin  7 , Yun Seong Park  1 , Gaonsorae Wang  1
Affiliations

Effect of emergency physician-operated emergency short-stay ward on emergency department stay length and clinical outcomes: a case-control study

Sean Moon et al. BMC Emerg Med. .

Abstract

Background: We hypothesized that an emergency short-stay ward (ESSW) mainly operated by emergency medicine physicians may reduce the length of patient stay in emergency department without expense of clinical outcomes.

Methods: We retrospectively analysed adult patients who visited the emergency department of the study hospital and were subsequently admitted to wards from 2017 to 2019. We divided study participants into three groups: patients admitted to ESSW and treated by the department of emergency medicine (ESSW-EM), patients admitted to ESSW and treated by other departments (ESSW-Other) and patients admitted to general wards (GW). The co-primary outcomes were ED length of stay and 28-day hospital mortality.

Results: In total, 29,596 patients were included in the study, and 8,328 (31.3%), 2,356 (8.9%), and 15,912 (59.8%) of them were classified as ESSW-EM, ESSW-Other and GW groups, respectively. The ED length of stay of the ESSW-EM (7.1 h ± 5.4) was shorter than those of the ESSW-Other (8.0 ± 6.2, P < 0.001) and the GW (10.2 ± 9.8, P < 0.001 for both). Hospital mortality of ESSW-EM (1.9%) was lower than that of GW (4.1%, P < 0.001). In the multivariable linear regression analysis, the ESSW-EM was independently associated with shorter ED length of stay compared with the both ESSW-Other (coefficient, 1.08; 95% confidence interval, 0.70-1.46; P < 0.001) and GW (coefficient, 3.35; 95% confidence interval, 3.12-3.57; P < 0.001). In the multivariable logistic regression analyses, the ESSW-EM was independently associated with lower hospital mortality compared with both the ESSW-Other group (adjusted P = 0.030) and the GW group (adjusted P < 0.001).

Conclusions: In conclusion, the ESSW-EM was independently associated with shorter ED length of stay compared with both the ESSW-Other and the GW in the adult ED patients. Independent association was found between the ESSW-EM and lower hospital mortality compared with the GW.

Keywords: Emergency Department; Emergency Short-Stay ward; Length of stay.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The study flow diagram EM, emergency medicine; ESSW, emergency short-stay ward; GW, general ward; ICU, intensive care unit
Fig. 2
Fig. 2
Distribution, ED stay length and hospital mortality according to the study group 2A: distribution of the participants according to the study group; 2B: ED stay length according to the study group; 2C: hospital mortality according to the study group ***P < 0.001 ED, emergency department; EM, emergency medicine; ESSW, emergency short-stay ward; GW, general ward
Fig. 3
Fig. 3
Distribution, ED stay length and hospital mortality according to the study group and visit year 3A: distribution of the participants according to the study group and visit year; 3B: ED stay length according to the study group and visit year; 3C: hospital mortality according to the study group and visit year **P < 0.01; ***P < 0.001 ED, emergency department; EM, emergency medicine; ESSW, emergency short-stay ward; GW, general ward
Fig. 4
Fig. 4
Distribution, ED stay length and hospital mortality according to the study group and KTAS level 4A: distribution of the participants according to the study group and KTAS level; 4B: ED stay length according to the study group and KTAS level; 4C: hospital mortality according to the study group and KTAS level *P < 0.05; **P < 0.01; ***P < 0.001 ED, emergency department; EM, emergency medicine; ESSW, emergency short-stay ward; GW, general ward; KTAS, Korean Triage and Acuity Scale
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