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Waiting times in California's emergency departments.
Ann Emerg Med. 2003 Jan; 41(1):35-44.AE

Abstract

STUDY OBJECTIVE

Many perceive emergency department crowding as a significant problem that is getting worse. A national survey of ED directors defined crowding, in part, as waiting more than 1 hour to see a physician, a wait considered likely to result in adverse outcomes. Yet few data are available on ED waiting times among a heterogeneous group of hospitals serving a distinct geographic region.

METHODS

We observed a random sample of 1,798 patients visiting 30 California EDs between December 15, 2000, and May 15, 2001. We defined waiting time as the interval from ED arrival to first contact with a physician or midlevel provider.

RESULTS

Patients waited an average of 56 minutes (95% confidence interval [CI] 52 to 61 minutes; median 38 minutes); 42% waited longer than 60 minutes. Ordinary least squares regression analysis revealed that waiting times were significantly longer at hospitals in poorer neighborhoods: For every 10,000 dollars decline in per capita income, patients waited 10.1 minutes longer (95% CI 1.8 to 18.4 minutes; P=.02) after adjusting for hospital ownership, teaching status, trauma status, proximity to a recently closed ED, ED volume, patient severity, and age. Lower ratios of physicians and triage nurses to waiting room patient were also associated with longer waits.

CONCLUSION

Waiting times often exceeded the threshold set by a survey of ED directors. Further study is required to examine factors that lead to longer waiting times at hospitals in low-income areas. Physician and nurse staffing should be investigated as a means of reducing waiting times.

Authors+Show Affiliations

Robert Wood Johnson Clinical Scholars' Program, University of California, Los Angeles, CA 94143, USA. slambs@itsa.ucsf.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

12514681

Citation

Lambe, Susan, et al. "Waiting Times in California's Emergency Departments." Annals of Emergency Medicine, vol. 41, no. 1, 2003, pp. 35-44.
Lambe S, Washington DL, Fink A, et al. Waiting times in California's emergency departments. Ann Emerg Med. 2003;41(1):35-44.
Lambe, S., Washington, D. L., Fink, A., Laouri, M., Liu, H., Scura Fosse, J., Brook, R. H., & Asch, S. M. (2003). Waiting times in California's emergency departments. Annals of Emergency Medicine, 41(1), 35-44.
Lambe S, et al. Waiting Times in California's Emergency Departments. Ann Emerg Med. 2003;41(1):35-44. PubMed PMID: 12514681.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Waiting times in California's emergency departments. AU - Lambe,Susan, AU - Washington,Donna L, AU - Fink,Arlene, AU - Laouri,Marianne, AU - Liu,Honghu, AU - Scura Fosse,Jessica, AU - Brook,Robert H, AU - Asch,Steven M, PY - 2003/1/7/pubmed PY - 2003/1/25/medline PY - 2003/1/7/entrez SP - 35 EP - 44 JF - Annals of emergency medicine JO - Ann Emerg Med VL - 41 IS - 1 N2 - STUDY OBJECTIVE: Many perceive emergency department crowding as a significant problem that is getting worse. A national survey of ED directors defined crowding, in part, as waiting more than 1 hour to see a physician, a wait considered likely to result in adverse outcomes. Yet few data are available on ED waiting times among a heterogeneous group of hospitals serving a distinct geographic region. METHODS: We observed a random sample of 1,798 patients visiting 30 California EDs between December 15, 2000, and May 15, 2001. We defined waiting time as the interval from ED arrival to first contact with a physician or midlevel provider. RESULTS: Patients waited an average of 56 minutes (95% confidence interval [CI] 52 to 61 minutes; median 38 minutes); 42% waited longer than 60 minutes. Ordinary least squares regression analysis revealed that waiting times were significantly longer at hospitals in poorer neighborhoods: For every 10,000 dollars decline in per capita income, patients waited 10.1 minutes longer (95% CI 1.8 to 18.4 minutes; P=.02) after adjusting for hospital ownership, teaching status, trauma status, proximity to a recently closed ED, ED volume, patient severity, and age. Lower ratios of physicians and triage nurses to waiting room patient were also associated with longer waits. CONCLUSION: Waiting times often exceeded the threshold set by a survey of ED directors. Further study is required to examine factors that lead to longer waiting times at hospitals in low-income areas. Physician and nurse staffing should be investigated as a means of reducing waiting times. SN - 0196-0644 UR - https://www.unboundmedicine.com/medline/citation/12514681/Waiting_times_in_California's_emergency_departments_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196064402849253 DB - PRIME DP - Unbound Medicine ER -