title: Emergency Department Overcrowding in Turkey: Reasons, Facts and Solutions.
abstract: BACKGROUND
  The purpose of this study was to determine the factors affecting the long waiting times of the patients in a university hospital.
  
  
  METHODS
  This study included 3000 of the adults above 18 years and pediatric trauma patients under 18 years who applied to emergency department between February 2009 and April 2009. The examination period of the physician, length of stay, length of hospitalization, waiting times for hospitalization and follow up times in the emergency department were recorded. Moreover, the patients were divided into four groups according to the reasons for waiting.
  
  
  RESULTS
  In our study, the time period between 4 pm-12 pm was determined as the busiest time for the applications. Average length of stay in the emergency department for 3000 patients was 146.7±160.2 minutes. The length of stay for the patients consulted was longer than the length of stay for the ones who were not consulted. Because of the fact that our hospital did not have appropriate bed capacity, 41.1% of the patients waited less than two hours, 13. 4% of the patients waited more than 8 hours. It was also found that the waiting times of the Group two patients (206,7±145,2 minutes) was longer than Group one (95,5±73,9 minutes) patients and the waiting times of Group three patients (470,7±364,7 minutes) was longer than Group one patients.
  
  
  CONCLUSIONS
  In conclusion, cooperation of the managers, relevant departments and a multidisciplinary approach are necessary to achieve the goals to reduce overcrowding in the emergency departments.
authors.affiliation: Emergency Medicine Clinic, Umraniye Training and Research Hospital, Istanbul.
authors.forename: O D
authors.initials: OD
authors.lastname: Cakir
authors.affiliation: Emergency Medicine Clinic, Umraniye Training and Research Hospital, Istanbul.
authors.forename: S E
authors.initials: SE
authors.lastname: Cevik
authors.affiliation: Department of Emergency Medicine,Medipol University School of Medicine, Istanbul.
authors.forename: M
authors.initials: M
authors.lastname: Bulut
authors.affiliation: Emergency Medicine Clinic, Dr Lutfi Kirdar Kartal Education and Research Hospital, Istanbul.
authors.forename: O
authors.initials: O
authors.lastname: Guneyses
authors.affiliation: Department of Emergency Medicine, Uludag University School of Medicine, Bursa, Turkey.
authors.forename: S A
authors.initials: SA
authors.lastname: Aydin
mesh_terms: D000328:Adult; D002648:Child; D017598:Efficiency, Organizational / Q000592:standards; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data; D004638:Emergency Treatment / Q000145:classification / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006300:Health Services Misuse / Q000517:prevention & control*; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D058996:Quality Improvement; D061665:Time-to-Treatment / Q000592:standards / Q000706:statistics & numerical data; D014218:Triage / Q000592:standards / Q000706:statistics & numerical data; D014421:Turkey
keywords: bed capacity; crowding; emergency department; length of stay.