Key result
Higher discharge-day ED census is linked to ~5% higher in-hospital mortality despite lower readmissions.
Why the study?
To examine the association of higher emergency department census with inpatient outcomes on the day of discharge, including for patients not admitted through the emergency department.
Does higher emergency department census on the day of discharge affect inpatient outcomes such as length of stay, mortality, and readmissions?
Population
5,784,253 inpatient discharges in non-federal general acute care hospitals with EDs in California
Comparison
Higher ED census on day of discharge vs ED census below the median
Design
Retrospective data analysis
Authors
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ED crowding on discharge day may affect inpatient outcomes; leaves open causal mechanisms and intervention effects.
Observational (n=5,784,253)
Yes
Does higher emergency department census on the day of discharge affect inpatient outcomes such as length of stay, mortality, and readmissions?
Emergency department crowding on the day of discharge is associated with increased inpatient length of stay and in-hospital mortality, suggesting hospital-wide impacts of ED congestion.
Hsuan et al. (2022) conducted an observational in Inpatient admission (n=5,784,253). Higher emergency department census on day of discharge vs. Emergency department census below the median was evaluated on Inpatient length of stay, 3-day ED revisit, 30-day all-cause readmission, and in-hospital mortality. Higher ED census on discharge day was associated with longer length of stay (+0.8%), lower readmissions (-5.6%), and higher in-hospital mortality (+5.4%) compared to below-median census.
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