ED overcrowding in Taiwan: Facts and strategies
Journal
American Journal of Emergency Medicine
Journal Volume
17
Journal Issue
2
Pages
198-202
Date Issued
1999
Author(s)
Shyu R.-S.
Wang S.-M.
Abstract
The objective of this study was to quantity the extent of emergency department (ED) overcrowding in Taiwan and to identify possible solutions. The ED log was reviewed for all patients who presented to the National Taiwan University Hospital's ED from January 16, 1996 through February 15, 1996. Charts from patients held longer than 72 hours were reviewed. Among 5,810 patients, 213 (3.6%) were held in the ED for more than 72 hours (7.1 patients per day). In 149 (70.0%) of them, admission was indicated but delayed (42 because more than one subspecialty were involved, 57 because of unavailability of bed, and 50 because of the disparity in admission priority between the emergency physicians and house staffs). Eighteen (8.4%) patients did not meet admission criteria (13 could have been treated in outpatient clinics, 3 needed placement in nursing homes, 2 because of personal problems). The others (22%) recovered while waiting. Significant overcrowding exists in EDs in Taiwan. Four solutions are proposed: (1) creation of a holding unit; (2) flexible ward assignment; (3) pre-established rules for admission priority-setting; and (4) active interfacility transfer. Only through these efforts can EDs in Taiwan guarantee an optimal level of care in the face of a growing patient demand.
SDGs
Other Subjects
article; crowding; emergency medicine; emergency ward; health care planning; hospital admission; hospital planning; hospitalization; human; length of stay; medical service; priority journal; Taiwan
Publisher
W.B. Saunders
Type
journal article