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Type of facility influences lengths of stay of children presenting to high volume emergency departments.
BMC Pediatr. 2020 11 02; 20(1):500.BPed

Abstract

BACKGROUND

Emergency department crowding may impact patient and provider outcomes. We describe emergency department crowding metrics based on presentations by children to different categories of high volume emergency departments in Alberta, Canada.

METHODS

This population-based retrospective study extracted all presentations made by children (age < 18 years) during April 2010 to March 2015 to 15 high volume emergency departments: five regional, eight urban, and two academic/teaching. Time to physician initial assessment, and length of stay for discharges and admissions were calculated based on the start of presentation and emergency department facility. Multiple metrics, including the medians for hourly, facility-specific time to physician initial assessment and length of stay were obtained.

RESULTS

About half (51.2%) of the 1,124,119 presentations were made to the two academic/teaching emergency departments. Males presented more than females (53.6% vs 46.4%) and the median age was 5 years. Pediatric presentations to the three categories of emergency departments had mostly similar characteristics; however, urban and academic/teaching emergency departments had more severe triage scores and academic/teaching emergency departments had higher admissions. Across all emergency departments, the medians of the metrics for time to physician initial assessment, length of stay for discharges and for admission were 1h11min, 2h21min, and 6h29min, respectively. Generally, regional hospitals had shorter times than urban and academic/teaching hospitals.

CONCLUSIONS

Pediatric presentations to high volume emergency departments in this province suggest similar delays to see providers; however, length of stay for discharges and admissions were shorter in regional emergency departments. Crowding is more common in urban and especially academic emergency departments and the impact of crowding on patient outcomes requires further study.

Authors+Show Affiliations

Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 3-524 Edmonton Clinic Health Academy, Edmonton, Alberta, T6G 1C9, Canada. rhonda.rosychuk@ualberta.ca. Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Alberta, Canada. rhonda.rosychuk@ualberta.ca. Department of Statistics and Actuarial Science, Simon Fraser University, Burnaby, British Columbia, Canada. rhonda.rosychuk@ualberta.ca.Department of Emergency Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, T6G 2R7, Canada. School of Public Health, University of Alberta, Edmonton, Alberta, Canada.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33131492

Citation

Rosychuk, Rhonda J., and Brian H. Rowe. "Type of Facility Influences Lengths of Stay of Children Presenting to High Volume Emergency Departments." BMC Pediatrics, vol. 20, no. 1, 2020, p. 500.
Rosychuk RJ, Rowe BH. Type of facility influences lengths of stay of children presenting to high volume emergency departments. BMC Pediatr. 2020;20(1):500.
Rosychuk, R. J., & Rowe, B. H. (2020). Type of facility influences lengths of stay of children presenting to high volume emergency departments. BMC Pediatrics, 20(1), 500. https://doi.org/10.1186/s12887-020-02400-6
Rosychuk RJ, Rowe BH. Type of Facility Influences Lengths of Stay of Children Presenting to High Volume Emergency Departments. BMC Pediatr. 2020 11 2;20(1):500. PubMed PMID: 33131492.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Type of facility influences lengths of stay of children presenting to high volume emergency departments. AU - Rosychuk,Rhonda J, AU - Rowe,Brian H, Y1 - 2020/11/02/ PY - 2020/06/05/received PY - 2020/10/21/accepted PY - 2020/11/2/entrez PY - 2020/11/3/pubmed PY - 2021/5/15/medline KW - Administrative data KW - Emergency department KW - Length of stay KW - Time to physician initial assessment KW - Wait times SP - 500 EP - 500 JF - BMC pediatrics JO - BMC Pediatr VL - 20 IS - 1 N2 - BACKGROUND: Emergency department crowding may impact patient and provider outcomes. We describe emergency department crowding metrics based on presentations by children to different categories of high volume emergency departments in Alberta, Canada. METHODS: This population-based retrospective study extracted all presentations made by children (age < 18 years) during April 2010 to March 2015 to 15 high volume emergency departments: five regional, eight urban, and two academic/teaching. Time to physician initial assessment, and length of stay for discharges and admissions were calculated based on the start of presentation and emergency department facility. Multiple metrics, including the medians for hourly, facility-specific time to physician initial assessment and length of stay were obtained. RESULTS: About half (51.2%) of the 1,124,119 presentations were made to the two academic/teaching emergency departments. Males presented more than females (53.6% vs 46.4%) and the median age was 5 years. Pediatric presentations to the three categories of emergency departments had mostly similar characteristics; however, urban and academic/teaching emergency departments had more severe triage scores and academic/teaching emergency departments had higher admissions. Across all emergency departments, the medians of the metrics for time to physician initial assessment, length of stay for discharges and for admission were 1h11min, 2h21min, and 6h29min, respectively. Generally, regional hospitals had shorter times than urban and academic/teaching hospitals. CONCLUSIONS: Pediatric presentations to high volume emergency departments in this province suggest similar delays to see providers; however, length of stay for discharges and admissions were shorter in regional emergency departments. Crowding is more common in urban and especially academic emergency departments and the impact of crowding on patient outcomes requires further study. SN - 1471-2431 UR - https://www.unboundmedicine.com/medline/citation/33131492/Type_of_facility_influences_lengths_of_stay_of_children_presenting_to_high_volume_emergency_departments_ L2 - https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-020-02400-6 DB - PRIME DP - Unbound Medicine ER -