The peer-reviewed scientific journal, Annals of Emergency Medicine, recently published a new online study entitled “Impact of Emergency Department Crowding on Outcomes of Admitted Patients.” This study presents the conclusion that “patients admitted to the hospital from the emergency department during periods of high crowding died more often than similar patients admitted to the same hospital when the emergency department was less crowded.” The study also found that crowding was “associated with longer overall hospital lengths of stay and increased costs per admission.”

The study’s lead author, Benjamin Sun, MD, a faculty member at the Oregon Health and Science University in Portland, said, “ER crowding is dangerous. We looked at nearly one million admissions through emergency departments across California, a large number of patients. Crowding was associated with five percent greater odds of inpatient death.”

Researchers analyzed 995,379 emergency department visits resulting in admission to 187 hospitals. Daily ambulance diversion—the practice of closing an emergency room to ambulances because it is too crowded to accept new patients—was the measure of emergency department crowding. Admission to the hospital from the emergency room on days with prolonged ambulance diversion (a median of seven hours)—or high emergency department crowding—was associated with 5 percent increased odds of dying in a hospital compared to admissions on days with low ambulance diversion (a median of zero hours).

Patients who were admitted on days with high emergency department crowding had 0.8 percent longer hospital stays and 1 percent increased costs per admission. Periods of high emergency department crowding were associated with 300 excess inpatient deaths, 6,200 hospital days, and $17 million in costs.

“Emergency department crowding is likely to become worse in the future because of the volume, complexity, and acuity of emergency patients,” said Dr. Sun. “Policy makers should address ER crowding as an important public health priority.”