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Emergency department overcrowding and ambulance diversion have been postulated to be linked to many factors, but only hospital census has been shown to be causative — and loosely at that (see Journal Watch Emergency Medicine Apr 15 2003). Researchers retrospectively analyzed more than 90,000 adult ED patient visits at a single level I inner-city ED to identify variables independently associated with increased ED length of stay (LOS).
The researchers measured numbers of elective surgical admissions, ED admissions, ICU admissions, and ED attending physician hours, as well as ED volume, hospital medical-surgical occupancy, and day of the week, per 24-hour period. They found that mean daily ED LOS per patient increased 0.21 minutes for every ele…