title: Hepatitis C Virus Screening and Emergency Department Length of Stay.
abstract: BACKGROUND
  Recent studies demonstrate high rates of previously undiagnosed hepatitis C virus (HCV) infection among patients screened in urban emergency departments (ED). Experts caution, however, that public health interventions, such as screening for infectious diseases, must not interfere with the primary mission of EDs to provide timely acute care. Increases in ED length of stay (LOS) have been associated with decreased quality of ED care.
  
  
  OBJECTIVE
  In this study, we assess the influence of an integrated HCV screening protocol on ED LOS.
  
  
  METHODS
  This was a retrospective cohort study analyzing timestamp data for all discharged patients over a 1-year period. The primary outcome compared the median LOS in minutes between patients who completed HCV screening and those who did not. Further analysis compared LOS for HCV screening by whether or not complete blood count (CBC) testing was conducted.
  
  
  RESULTS
  Of 69,639 visits, 2,864 (4%) had HCV screening tests completed and 272 (9.5%) were antibody positive. The median LOS for visits that included HCV screening was greater than visits that did not include screening (151 versus 119 minutes, P < 0.001). Among the subset of visits in which CBC testing was conducted, there was no significant difference in median LOS between visits that also included HCV screening and those that did not (240 versus 242 minutes, P = 0.68).
  
  
  CONCLUSIONS
  Integrated HCV screening modestly prolongs ED LOS. However, among patients undergoing other blood tests, screening had no effect on LOS. Programs may consider routinely offering HCV screening to patients who are undergoing laboratory testing.
authors.affiliation: Department of Emergency Medicine, Alameda Health System, Highland Hospital, Oakland, CA, United States of America.
authors.forename: Douglas A E
authors.initials: DA
authors.lastname: White
authors.affiliation: Department of Emergency Medicine, Alameda Health System, Highland Hospital, Oakland, CA, United States of America.|Department of Emergency Medicine, Stanford University, Palo Alto, CA, United States of America.
authors.forename: Erik S
authors.initials: ES
authors.lastname: Anderson
authors.affiliation: Department of Emergency Medicine, Alameda Health System, Highland Hospital, Oakland, CA, United States of America.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Pfeil
authors.affiliation: Department of Emergency Medicine, Alameda Health System, Highland Hospital, Oakland, CA, United States of America.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Deering
authors.affiliation: Department of Emergency Medicine, Alameda Health System, Highland Hospital, Oakland, CA, United States of America.
authors.forename: Tamara
authors.initials: T
authors.lastname: Todorovic
authors.affiliation: Department of Emergency Medicine, Alameda Health System, Highland Hospital, Oakland, CA, United States of America.
authors.forename: Tarak K
authors.initials: TK
authors.lastname: Trivedi
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008403:Mass Screening; D010351:Patient Discharge / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000706:statistics & numerical data; D012189:Retrospective Studies