Rural-urban differences in emergency department wait times
Abstract
INTRODUCTION: I sought to determine whether emergency department (ED) volume is associated with differing ED wait times.
METHODS: I conducted a retrospective analysis of the Emergency Department Reporting System database of the Ontario Ministry of Health. I abstracted ED length of stay for patient visits to 117 hospital EDs during the second quarter of 2008, representing 89% of ED visits in the province during that period. Annual volume of ED visits, lengths of stay in the ED and acuity levels of patients were measured.
RESULTS: All EDs were more efficient in managing the treatment of low-acuity patients compared with high-acuity patients. Small rural EDs in Ontario had the shortest wait times for both high- and low-acuity patients (medians 2.35 h for high-acuity and 1.46 h for low-acuity patients in small rural EDs v. 4.98 h for high-acuity and 2.85 h for low-acuity patients in teaching hospitals).
CONCLUSION: Among the hospitals studied, rural EDs had the shortest wait times for both low- and high-acuity patients.
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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