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Boarding in US Academic Emergency Departments During the COVID-19 Pandemic

STUDY OBJECTIVE: The first 2 years of the COVID-19 pandemic brought substantial and dynamic changes to emergency department volumes and throughput. The objective of this study was to describe changes in ED boarding among US academic EDs across the duration of the COVID-19 pandemic. METHODS: We condu...

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Autores principales: Kilaru, Austin S., Scheulen, James J., Harbertson, Cathi A., Gonzales, Rachel, Mondal, Angira, Agarwal, Anish K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: by the American College of Emergency Physicians. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9851166/
https://www.ncbi.nlm.nih.gov/pubmed/36681622
http://dx.doi.org/10.1016/j.annemergmed.2022.12.004
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author Kilaru, Austin S.
Scheulen, James J.
Harbertson, Cathi A.
Gonzales, Rachel
Mondal, Angira
Agarwal, Anish K.
author_facet Kilaru, Austin S.
Scheulen, James J.
Harbertson, Cathi A.
Gonzales, Rachel
Mondal, Angira
Agarwal, Anish K.
author_sort Kilaru, Austin S.
collection PubMed
description STUDY OBJECTIVE: The first 2 years of the COVID-19 pandemic brought substantial and dynamic changes to emergency department volumes and throughput. The objective of this study was to describe changes in ED boarding among US academic EDs across the duration of the COVID-19 pandemic. METHODS: We conducted a retrospective analysis of monthly data collected from a convenience sample of academic departments of emergency medicine. The study period was from January 2019 to December 2021. The primary outcome was total boarding hours, and secondary outcomes included patient volume stratified by ED disposition. We used multivariable linear panel regression models with fixed effects for individual EDs to estimate adjusted means for 3-month quarters. RESULTS: Of the 73 academic departments of emergency medicine contacted, 34 (46.6%) participated, comprising 43 individual EDs in 25 states. The adjusted mean total boarding hours per month significantly decreased during the second quarter of 2020 (4,449 hours; 95% confidence interval [CI] 3,189 to 5,710) compared to the first quarter of 2019 (8,521 hours; 95% CI 7,845 to 9,197). Beginning in the second quarter of 2021, total boarding hours significantly increased beyond pre-pandemic levels, peaking during the fourth quarter of 2021 (12,127 hours; 95% CI 10,925 to 13,328). CONCLUSIONS: A sustained and considerable increase in boarding observed in selected US academic EDs during later phases of the COVID-19 pandemic may reflect ongoing stresses to the health care system, with potential consequences for patient outcomes as well as clinician well-being.
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spelling pubmed-98511662023-01-20 Boarding in US Academic Emergency Departments During the COVID-19 Pandemic Kilaru, Austin S. Scheulen, James J. Harbertson, Cathi A. Gonzales, Rachel Mondal, Angira Agarwal, Anish K. Ann Emerg Med Health Policy/Brief Research Report STUDY OBJECTIVE: The first 2 years of the COVID-19 pandemic brought substantial and dynamic changes to emergency department volumes and throughput. The objective of this study was to describe changes in ED boarding among US academic EDs across the duration of the COVID-19 pandemic. METHODS: We conducted a retrospective analysis of monthly data collected from a convenience sample of academic departments of emergency medicine. The study period was from January 2019 to December 2021. The primary outcome was total boarding hours, and secondary outcomes included patient volume stratified by ED disposition. We used multivariable linear panel regression models with fixed effects for individual EDs to estimate adjusted means for 3-month quarters. RESULTS: Of the 73 academic departments of emergency medicine contacted, 34 (46.6%) participated, comprising 43 individual EDs in 25 states. The adjusted mean total boarding hours per month significantly decreased during the second quarter of 2020 (4,449 hours; 95% confidence interval [CI] 3,189 to 5,710) compared to the first quarter of 2019 (8,521 hours; 95% CI 7,845 to 9,197). Beginning in the second quarter of 2021, total boarding hours significantly increased beyond pre-pandemic levels, peaking during the fourth quarter of 2021 (12,127 hours; 95% CI 10,925 to 13,328). CONCLUSIONS: A sustained and considerable increase in boarding observed in selected US academic EDs during later phases of the COVID-19 pandemic may reflect ongoing stresses to the health care system, with potential consequences for patient outcomes as well as clinician well-being. by the American College of Emergency Physicians. 2023-01-19 /pmc/articles/PMC9851166/ /pubmed/36681622 http://dx.doi.org/10.1016/j.annemergmed.2022.12.004 Text en © 2022 by the American College of Emergency Physicians. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Health Policy/Brief Research Report
Kilaru, Austin S.
Scheulen, James J.
Harbertson, Cathi A.
Gonzales, Rachel
Mondal, Angira
Agarwal, Anish K.
Boarding in US Academic Emergency Departments During the COVID-19 Pandemic
title Boarding in US Academic Emergency Departments During the COVID-19 Pandemic
title_full Boarding in US Academic Emergency Departments During the COVID-19 Pandemic
title_fullStr Boarding in US Academic Emergency Departments During the COVID-19 Pandemic
title_full_unstemmed Boarding in US Academic Emergency Departments During the COVID-19 Pandemic
title_short Boarding in US Academic Emergency Departments During the COVID-19 Pandemic
title_sort boarding in us academic emergency departments during the covid-19 pandemic
topic Health Policy/Brief Research Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9851166/
https://www.ncbi.nlm.nih.gov/pubmed/36681622
http://dx.doi.org/10.1016/j.annemergmed.2022.12.004
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