Execution of diagnostic testing has a stronger effect on emergency department crowding than other common factors: a cross-sectional study
We compared the effects of execution of diagnostic tests in the emergency department (ED) and other common factors on the length of ED stay to identify those with the greatest impacts on ED crowding. Between February 2010 and January 2012, we conducted a cross-sectional, single-center study in the E...
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| creator | Kawano, Takahisa Nishiyama, Kei Hayashi, Hiroyuki |
| description | We compared the effects of execution of diagnostic tests in the emergency department (ED) and other common factors on the length of ED stay to identify those with the greatest impacts on ED crowding.
Between February 2010 and January 2012, we conducted a cross-sectional, single-center study in the ED of a large, urban, teaching hospital in Japan. Patients who visited the ED during the study period were enrolled. We excluded (1) patients scheduled for admission or pharmaceutical prescription, and (2) neonates requiring intensive care transferred from other hospitals. Multivariate linear regression was performed on log-transformed length of ED stay in admitted and discharged patients to compare influence of diagnostic tests and other common predictors. To quantify the range of change in length of ED stay given a unit change of the predictor, a generalized linear model was used for each group.
During the study period, 55,285 patients were enrolled. In discharged patients, laboratory blood tests had the highest standardized β coefficient (0.44) among common predictors, and increased length of ED stay by 72.5 minutes (95% CI, 72.8-76.1 minutes). In admitted patients, computed tomography (CT) had the highest standardized β coefficient (0.17), and increased length of ED stay by 32.7 minutes (95% CI, 40.0-49.9 minutes). Although other common input and output factors were significant contributors, they had smaller standardized β coefficients in both groups.
Execution of laboratory blood tests and CT had a stronger influence on length of ED stay than other common input and output factors. |
| doi_str_mv | 10.1371/journal.pone.0108447 |
| format | Article |
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Between February 2010 and January 2012, we conducted a cross-sectional, single-center study in the ED of a large, urban, teaching hospital in Japan. Patients who visited the ED during the study period were enrolled. We excluded (1) patients scheduled for admission or pharmaceutical prescription, and (2) neonates requiring intensive care transferred from other hospitals. Multivariate linear regression was performed on log-transformed length of ED stay in admitted and discharged patients to compare influence of diagnostic tests and other common predictors. To quantify the range of change in length of ED stay given a unit change of the predictor, a generalized linear model was used for each group.
During the study period, 55,285 patients were enrolled. In discharged patients, laboratory blood tests had the highest standardized β coefficient (0.44) among common predictors, and increased length of ED stay by 72.5 minutes (95% CI, 72.8-76.1 minutes). In admitted patients, computed tomography (CT) had the highest standardized β coefficient (0.17), and increased length of ED stay by 32.7 minutes (95% CI, 40.0-49.9 minutes). Although other common input and output factors were significant contributors, they had smaller standardized β coefficients in both groups.
Execution of laboratory blood tests and CT had a stronger influence on length of ED stay than other common input and output factors.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0108447</identifier><identifier>PMID: 25310089</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Blood ; Blood tests ; Coefficients ; Computed tomography ; Critical care ; Cross-Sectional Studies ; Crowding ; Diagnostic systems ; Diagnostic tests ; Diagnostic Tests, Routine ; Electrocardiography ; Emergency medical care ; Emergency medical services ; Emergency service ; Emergency Service, Hospital ; Emergency services ; Female ; Geriatrics ; Hospitals ; Hospitals, Teaching ; Humans ; Identification methods ; Intensive care ; Laboratories ; Length of Stay ; Male ; Medical diagnosis ; Medical examination ; Medicine ; Medicine and Health Sciences ; Middle Aged ; Neonates ; Patients ; Pediatrics ; Pharmaceuticals ; Registration ; Statistical models ; Time Factors ; Young Adult</subject><ispartof>PloS one, 2014-10, Vol.9 (10), p.e108447-e108447</ispartof><rights>COPYRIGHT 2014 Public Library of Science</rights><rights>2014 Kawano et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2014 Kawano et al 2014 Kawano et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c775t-bd37542755ca87fcc9b45f64cc43f08f0674d51610b878943780e3b96d1e00433</citedby><cites>FETCH-LOGICAL-c775t-bd37542755ca87fcc9b45f64cc43f08f0674d51610b878943780e3b96d1e00433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195592/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195592/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25310089$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Schmidt, Robert Lane</contributor><creatorcontrib>Kawano, Takahisa</creatorcontrib><creatorcontrib>Nishiyama, Kei</creatorcontrib><creatorcontrib>Hayashi, Hiroyuki</creatorcontrib><title>Execution of diagnostic testing has a stronger effect on emergency department crowding than other common factors: a cross-sectional study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>We compared the effects of execution of diagnostic tests in the emergency department (ED) and other common factors on the length of ED stay to identify those with the greatest impacts on ED crowding.
Between February 2010 and January 2012, we conducted a cross-sectional, single-center study in the ED of a large, urban, teaching hospital in Japan. Patients who visited the ED during the study period were enrolled. We excluded (1) patients scheduled for admission or pharmaceutical prescription, and (2) neonates requiring intensive care transferred from other hospitals. Multivariate linear regression was performed on log-transformed length of ED stay in admitted and discharged patients to compare influence of diagnostic tests and other common predictors. To quantify the range of change in length of ED stay given a unit change of the predictor, a generalized linear model was used for each group.
During the study period, 55,285 patients were enrolled. In discharged patients, laboratory blood tests had the highest standardized β coefficient (0.44) among common predictors, and increased length of ED stay by 72.5 minutes (95% CI, 72.8-76.1 minutes). In admitted patients, computed tomography (CT) had the highest standardized β coefficient (0.17), and increased length of ED stay by 32.7 minutes (95% CI, 40.0-49.9 minutes). Although other common input and output factors were significant contributors, they had smaller standardized β coefficients in both groups.
Execution of laboratory blood tests and CT had a stronger influence on length of ED stay than other common input and output factors.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Blood</subject><subject>Blood tests</subject><subject>Coefficients</subject><subject>Computed tomography</subject><subject>Critical care</subject><subject>Cross-Sectional Studies</subject><subject>Crowding</subject><subject>Diagnostic systems</subject><subject>Diagnostic tests</subject><subject>Diagnostic Tests, Routine</subject><subject>Electrocardiography</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Emergency service</subject><subject>Emergency Service, Hospital</subject><subject>Emergency services</subject><subject>Female</subject><subject>Geriatrics</subject><subject>Hospitals</subject><subject>Hospitals, Teaching</subject><subject>Humans</subject><subject>Identification methods</subject><subject>Intensive care</subject><subject>Laboratories</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medical examination</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Neonates</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Pharmaceuticals</subject><subject>Registration</subject><subject>Statistical models</subject><subject>Time Factors</subject><subject>Young 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one</jtitle><addtitle>PLoS One</addtitle><date>2014-10-13</date><risdate>2014</risdate><volume>9</volume><issue>10</issue><spage>e108447</spage><epage>e108447</epage><pages>e108447-e108447</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>We compared the effects of execution of diagnostic tests in the emergency department (ED) and other common factors on the length of ED stay to identify those with the greatest impacts on ED crowding.
Between February 2010 and January 2012, we conducted a cross-sectional, single-center study in the ED of a large, urban, teaching hospital in Japan. Patients who visited the ED during the study period were enrolled. We excluded (1) patients scheduled for admission or pharmaceutical prescription, and (2) neonates requiring intensive care transferred from other hospitals. Multivariate linear regression was performed on log-transformed length of ED stay in admitted and discharged patients to compare influence of diagnostic tests and other common predictors. To quantify the range of change in length of ED stay given a unit change of the predictor, a generalized linear model was used for each group.
During the study period, 55,285 patients were enrolled. In discharged patients, laboratory blood tests had the highest standardized β coefficient (0.44) among common predictors, and increased length of ED stay by 72.5 minutes (95% CI, 72.8-76.1 minutes). In admitted patients, computed tomography (CT) had the highest standardized β coefficient (0.17), and increased length of ED stay by 32.7 minutes (95% CI, 40.0-49.9 minutes). Although other common input and output factors were significant contributors, they had smaller standardized β coefficients in both groups.
Execution of laboratory blood tests and CT had a stronger influence on length of ED stay than other common input and output factors.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>25310089</pmid><doi>10.1371/journal.pone.0108447</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Blood Blood tests Coefficients Computed tomography Critical care Cross-Sectional Studies Crowding Diagnostic systems Diagnostic tests Diagnostic Tests, Routine Electrocardiography Emergency medical care Emergency medical services Emergency service Emergency Service, Hospital Emergency services Female Geriatrics Hospitals Hospitals, Teaching Humans Identification methods Intensive care Laboratories Length of Stay Male Medical diagnosis Medical examination Medicine Medicine and Health Sciences Middle Aged Neonates Patients Pediatrics Pharmaceuticals Registration Statistical models Time Factors Young Adult |
| title | Execution of diagnostic testing has a stronger effect on emergency department crowding than other common factors: a cross-sectional study |
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