Henneman Philip L, Nathanson Brian H, Li Haiping, Smithline Howard A, Blank Fidela S J, Santoro John P, Maynard Ann M, Provost Deborah A, Henneman Elizabeth A
Department of Emergency Medicine, Baystate Medical Center, Springfield, Massachusetts 01199, USA.
J Emerg Med. 2010 Jul;39(1):105-12. doi: 10.1016/j.jemermed.2008.08.018. Epub 2009 Jan 20.
Admitted and discharged patients with prolonged emergency department (ED) stays may contribute to crowding by utilizing beds and staff time that would otherwise be used for new patients.
To describe patients who stay > 6 h in the ED and determine their association with measures of crowding.
This was a retrospective, observational study carried out over 1 year at a single, urban, academic ED.
Of the 96,562 patients seen, 16,017 (17%) stayed > 6 h (51% admitted). When there was at least one patient staying > 6 h, 60% of the time there was at least one additional patient in the waiting room who could not be placed in an ED bed because none was open. The walk-out rate was 0.34 patients/hour when there were no patients staying in the ED > 6 h, vs. 0.77 patients/hour walking out when there were patients staying > 6 h in the ED (p < 0.001). When the ED contained more than 3 patients staying > 6 h, a trend was noted between increasing numbers of patients staying in the ED > 6 h and the percentage of time the ED was on ambulance diversion (p = 0.011).
In our ED, having both admitted and discharged patients staying > 6 h is associated with crowding.
急诊室（ED）停留时间延长的入院和出院患者可能会占用床位和工作人员时间，从而导致拥挤，而这些资源原本可用于新患者。
描述在急诊室停留超过6小时的患者，并确定他们与拥挤程度指标之间的关联。
这是一项在一家城市学术急诊室进行的为期1年的回顾性观察研究。
在96562名就诊患者中，16017名（17%）停留超过6小时（51%入院）。当至少有一名患者停留超过6小时时，60%的时间里，急诊室候诊室至少还有一名患者因没有空床位而无法安置。当急诊室没有停留超过6小时的患者时，患者离开率为每小时0.34人，而当急诊室有停留超过6小时的患者时，患者离开率为每小时0.77人（p<0.001）。当急诊室有超过3名患者停留超过6小时时，观察到急诊室停留超过6小时的患者数量增加与急诊室因救护车分流而关闭的时间百分比之间存在一种趋势（p=0.011）。
在我们的急诊室，入院和出院患者停留超过6小时均与拥挤有关。
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