title: Impact of an acute medical admission unit on length of hospital stay, and emergency department 'wait times'.
abstract: BACKGROUND
  While many UK hospitals have introduced an acute medical admissions unit (AMAU) to facilitate an efficient emergency admission process and reduce length of hospital stay (LOS), there is a lack of such data in the Republic of Ireland.
  
  
  OBJECTIVE
  To determine the impact of an AMAU on emergency department (ED) wait times for a hospital bed, consultant practice, and LOS.
  
  
  METHODS
  Retrospective analysis of data recorded in the hospital in-patient enquiry (HIPE) system.
  
  
  METHODS
  We studied all emergency medical patients admitted to St James' Hospital Dublin between 1 January 2002 and 31 December 2003. In 2002, patients were admitted directly to a variety of wards, many of which were not affiliated with a medical specialty, under the care of a named consultant physician. In 2003, two centrally located wards were re-configured to function as an AMAU, and all emergency patients were admitted to this unit.
  
  
  RESULTS
  For all physician teams, median LOS shortened significantly from 2002 to 2003 (6 vs. 5 days, p<0.0001). Overall, patients seen by general physicians had a shorter LOS (5 days) than that of those seen by sub-specialists (6 days) (p<0.0001). The number of patients waiting in the ED for a hospital bed was reduced by 30% from 2002 to 2003 (p<0.001). Extrapolated cost savings for the hospital with the introduction of the AMAU were estimated at approximately 4039 bed-days and 1 714 152.
  
  
  CONCLUSIONS
  Introduction of the AMAU speeded access to acute medical service and reduced costs.
authors.affiliation: Division of Internal Medicine St. James' Hospital, Trinity College Dublin, James' Street, Dublin 8, Ireland.
authors.forename: E D
authors.initials: ED
authors.lastname: Moloney
authors.forename: D
authors.initials: D
authors.lastname: Smith
authors.forename: K
authors.initials: K
authors.lastname: Bennett
authors.forename: D
authors.initials: D
authors.lastname: O'riordan
authors.forename: B
authors.initials: B
authors.lastname: Silke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis / Q000379:methods; D004632:Emergency Medical Services / Q000191:economics / Q000458:organization & administration*; D005260:Female; D006295:Health Resources / Q000191:economics; D006801:Humans; D007494:Ireland; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000191:economics / Q000639:trends; D012189:Retrospective Studies; D013997:Time Factors