Paediatric emergency department overcrowding and adverse patient outcomes

Paediatrics & Child Health
Melissa ChanQuynh Doan

Abstract

General emergency department crowding negatively impacts patient care, and increases patient morbidity. This study seeks to determine if markers of paediatric emergency department (PED) flow are independently associated with negative outcomes and increased health care utilization. We conducted a retrospective cohort study of PED visits from 2008 to 2012. Data were pulled from an electronic administrative database. Using multivariate logistic regression models, we measured the association between odds of adverse outcomes (hospital/paediatric intensive care unit [PICU] admission, unscheduled return visits and mortality) with markers of PED flow (shift mean length of stay [LOS] and daily rate of patients leaving without being seen [LWBS]). We found an association between the daily LWBS proportion and the odds of being admitted to the hospital (odds ratio [OR]: 2.1; 95% confidence interval [CI]: 1.2, 3.7), as well as admission to the PICU (OR: 8.9; 95% CI: 1.1, 71.3). We found a statistically significant increase in the odds of admission if seen during shifts in the third or fourth quartile mean shift LOS. We observed lower odds of returning to the PED with increased daily LWBS proportions (OR: 0.4; 95% CI: 0.2, 0.7), but found no ...Continue Reading

References

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Citations

Jul 24, 2020·Journal for Specialists in Pediatric Nursing : JSPN·Xian CaiPeiqing Li
Oct 20, 2020·Frontiers in Pediatrics·Francesco ValituttiPietro Vajro
Apr 30, 2021·Advanced Emergency Nursing Journal·Camille Brockett-WalkerSheryl Heron
Feb 6, 2020·Pediatric Emergency Care·Katherine A NashRomain Guedj

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