Trends in boarding of admitted patients in US Emergency Departments 2003-2005.
BACKGROUND
Boarding of admitted patients in the Emergency Department (ED) is common and is associated with poor patient outcomes.


OBJECTIVE
We sought to estimate the magnitude of and trends for ED boarding in the US.


METHODS
We used the 2003-2005 National Hospital Ambulatory Medical Care Survey to estimate the time patients spent boarding in EDs in the US. We used fixed and imputed times required to evaluate, treat, and decide to admit each patient using the number of medications and diagnostic tests received. We calculated the absolute and relative patient-care hours spent boarding in US EDs over the 3-year period.


RESULTS
Total patient-hours spent in US EDs increased from 209 million to 217 million between 2003 and 2005. Overall admission rates decreased between 2003 and 2005 (13.9% in 2003, 12.3% in 2005), whereas intensive care unit admission rates increased (1.3% in 2003, 2.0% in 2005). Mean ED length of stay decreased (5.4 h in 2003, 4.6 h in 2005). The proportion of patient-hours accounted for by ED boarding decreased over the study period (11.3-17.1% in 2003, 5.9-15.3% in 2004, and 2.8-12.0% 2005).


CONCLUSIONS
Boarding of admitted patients in the ED accounts for a substantial portion of ED patient-care hours. Overall boarding time decreased over the 3 years.
Carr
Brendan G
BG
Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-6021, USA.
Hollander
Judd E
JE
Baxt
William G
WG
Datner
Elizabeth M
EM
Pines
Jesse M
JM
D001509:Bed Occupancy; D003441:Crowding; D003710:Demography; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data* / Q000639:trends*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000639:trends*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016134:Organizational Policy; D010343:Patient Admission / Q000639:trends*; D010360:Patient Transfer / Q000639:trends*; D014481:United States