Safety-Net Status Not Linked to ER Length of Stay

Compliance with length-of-stay measures for admission, discharge, observation, transfer similar

TUESDAY, Jan. 31 (HealthDay News) -- There is no significant difference in compliance with emergency department length-of-stay measures for admissions, discharges, observations, and transfers between safety-net and non-safety-net hospitals, according to a study published in the Feb. 1 issue of the Journal of the American Medical Association.

Christopher Fee, M.D., from the University of California San Francisco, and colleagues reviewed the 2008 National Hospital Ambulatory Medical Care Survey emergency department data for 396 hospitals and 34,134 patient records to describe compliance with proposed length-of-stay measures for admissions, discharges, transfers, and observations according to hospital safety-net status.

The investigators found that 42.3 percent of the 24,719 emergency department visits included in the analyses were to safety-net emergency departments, and 57.7 percent were to non-safety-net emergency departments. The median length of stay for safety-net versus non-safety-net emergency departments was 269 versus 281 minutes for admissions (odds ratio [OR], 0.83; 95 percent confidence interval [CI], 0.52 to 1.34); 156 versus 148 minutes for discharge (OR, 1.03; 95 percent CI, 0.83 to 1.27); 355 versus 298 minutes for observations (OR, 1.05; 95 percent CI, 0.57 to 1.95); and 235 versus 239 minutes for transfers (OR, 1.30; 95 percent CI, 0.70 to 2.45). There was no correlation between safety-net status and compliance with emergency department length-of-stay measures or subcategories, except for psychiatric discharges (OR, 1.67; 95 percent CI, 1.02 to 2.74).

"Compliance with proposed emergency department length-of-stay measures for admitted, discharged, transferred, and observed patients do not differ between safety-net and non-safety-net hospitals and could be a useful measure for assessing throughput across these institutions," the authors write.

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