Assessing the Impact of External and Internal Factors on Emergency Department Overcrowding
Journal:
arXiv
Published Date:
Apr 25, 2025
Abstract
Study Objective: To analyze the factors influencing Emergency Department (ED)
overcrowding by examining the impacts of operational, environmental, and
external variables, including weather conditions and football games.
Methods: This study integrates ED tracking and hospital census data from a
southeastern U.S. academic medical center (2019-2023) with data from external
sources, including weather, football events, and federal holidays. The
dependent variable is the hourly waiting count in the ED. Seven regression
models were developed to assess the effects of different predictors such as
weather conditions, hospital census, federal holidays, and football games
across different timestamps.
Results: Some weather conditions significantly increased ED crowding in the
Baseline Model, while federal holidays and weekends consistently reduced
waiting counts. Boarding count positively correlated with ED crowding when they
are concurrent, but earlier boarding count (3-6 hours before) showed
significant negative associations, reducing subsequent waiting counts. Hospital
census exhibited a negative association in the Baseline Model but shifted to a
positive effect in other models, reflecting its time-dependent influence on ED
operations. Football games 12 hours before significantly increased waiting
counts, while games 12 and 24 hours after had no significant effects.
Conclusion: This study highlights the importance of incorporating both
operational and non-operational factors (e.g., weather) to understand ED
patient flow. Identifying robust predictors such as weather, federal holidays,
boarding count, and hospital census can inform dynamic resource allocation
strategies to mitigate ED overcrowding effectively.
