title: General Characteristics and Activity of Emergency Department Short-Stay Units in Spanish Hospitals.
abstract: BACKGROUND
  Emergency Department (ED) overcrowding mainly due to the lack of access to inpatient beds negatively affects safety and quality of care. Implementation of ED short-stay units (EDSSUs) may help to mitigate this situation.
  
  
  OBJECTIVE
  To describe the general characteristics and evaluate the activity of EDSSUs in Spanish hospitals.
  
  
  METHODS
  This is a cross-sectional study. A questionnaire was sent to coordinators responsible for the EDSSUs identified among Spanish hospitals appearing on the Ministry of Health Web page. Data regarding structure, caseloads, and clinical management practices were collected.
  
  
  RESULTS
  Among the 591 hospitals surveyed, 35 EDSSUs (5.9%) were identified and 23 participated in the study. Admissions to EDSSUs over different periods in 2011 were assessed: 12-month activity in 17 EDSSUs and between 5 and 10.5 months in six EDSSUs. A total of 25,568 patients with a mean age of 67.2 ± 9.8 years were admitted, representing between 6% and 16.3% of hospital admissions from the ED. The most frequent diagnoses were acute heart failure, chronic obstructive pulmonary disease exacerbation, and urinary and respiratory tract infections. The average length of stay (LOS) was 2.6 ± 1.1 days (range 1.2-5.3), in-hospital mortality 0.59% (range 0-2.68), and the 30-day readmission rate after discharge was 6.7% (range 0-14.6).
  
  
  CONCLUSIONS
  To date, only a few Spanish hospitals have implemented EDSSUs. Prevalent infections and exacerbation of chronic conditions are the most frequent causes for admission. Considering LOS, 30-day readmission rate and mortality, EDSSUs appear to be safe and effective and might be considered a tool to alleviate ED overcrowding.
authors.affiliation: Emergency Department, Hospital Universitari de Bellvitge, Barcelona, Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Ferré
authors.affiliation: Emergency Department, Hospital Universitari de Bellvitge, Barcelona, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Llopis
authors.affiliation: Emergency Department, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Martín-Sánchez
authors.affiliation: Short-stay Unit, Hospital Universitario Dr. Peset, Valencia, Spain.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Sempere
authors.affiliation: Emergency Department, Hospital General Universitario de Alicante, Alicante, Spain.
authors.forename: Pere
authors.initials: P
authors.lastname: Llorens
authors.affiliation: Emergency Department, Hospital Universitario Virgen de la Macarena, Sevilla, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro
authors.affiliation: Emergency Department, Hospital Universitario de Basurto, Bilbao, Spain.
authors.forename: Mikel
authors.initials: M
authors.lastname: Martínez-Ortiz
authors.affiliation: Institut Català de la Salut, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Juan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003441:Crowding; D004636:Emergency Service, Hospital / Q000145:classification* / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D013030:Spain; D011795:Surveys and Questionnaires
keywords: emergency department; emergency department overcrowding; short-stay unit