title: New Intervention Model of Regional Transfer Network System to Alleviate Crowding of Regional Emergency Medical Center.
abstract: Emergency department (ED) crowding is a serious problem in most tertiary hospitals in Korea. Although several intervention models have been established to alleviate ED crowding, they are limited to a single hospital-based approach. This study was conducted to determine whether the new regional intervention model could alleviate ED crowding in a regional emergency medical center. This study was designed as a "before and after study" and included patients who visited the tertiary hospital ED from November 2011 to October 2013. One tertiary hospital and 32 secondary hospitals were included in the study. A transfer coordinator conducted inter-hospital transfers from a tertiary hospital to a secondary hospital for suitable patients. A total of 1,607 and 2,591 patients transferred from a tertiary hospital before and after the study, respectively (P < 0.001). We found that the median ED length of stay (LOS) decreased significantly from 3.68 hours (interquartile range [IQR], 1.85 to 9.73) to 3.20 hours (IQR, 1.62 to 8.33) in the patient group after implementation of the Regional Transfer Network System (RTNS) (P < 0.001). The results of multivariate analysis showed a negative association between implementation of the RTNS and ED LOS (beta coefficient -0.743; 95% confidence interval -0.914 to -0.572; P < 0.001). In conclusion, the ED LOS in the tertiary hospital decreased after implementation of the RTNS.
authors.affiliation: Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea .
authors.forename: Jae Yun
authors.identifier: 0000-0002-1050-8575
authors.initials: JY
authors.lastname: Ahn
authors.affiliation: Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea .
authors.forename: Hyun Wook
authors.identifier: 0000-0002-1361-9887
authors.initials: HW
authors.lastname: Ryoo
authors.affiliation: Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea .
authors.forename: Jungbae
authors.identifier: 0000-0003-4104-5857
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea .
authors.forename: Jong Kun
authors.identifier: 0000-0002-0583-4368
authors.initials: JK
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea .
authors.forename: Mi Jin
authors.identifier: 0000-0002-3773-8047
authors.initials: MJ
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine, Catholic University of Daegu College of Medicine, Daegu, Korea .
authors.forename: Jong-Yeon
authors.identifier: 0000-0002-4478-6127
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea .
authors.forename: Sang Do
authors.identifier: 0000-0003-4953-2916
authors.initials: SD
authors.lastname: Shin
authors.affiliation: Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea .
authors.forename: Won Chul
authors.identifier: 0000-0002-2778-2992
authors.initials: WC
authors.lastname: Cha
authors.affiliation: Department of Emergency Medicine, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Seoul, Korea .
authors.forename: Jun Seok
authors.identifier: 0000-0002-7962-7097
authors.initials: JS
authors.lastname: Seo
authors.affiliation: Public Health and Welfare Bureau, Daegu Metropolitan City Hall, Daegu, Korea .
authors.forename: Young Ae
authors.identifier: 0000-0002-1312-4147
authors.initials: YA
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D015999:Multivariate Analysis; D012017:Referral and Consultation; D056910:Republic of Korea; D062606:Tertiary Care Centers; D055815:Young Adult
keywords: Crowding; Emergency Medicine; Referral and Consultation; Tertiary Care Centers