19Feb 2020

FACTORS ASSOCIATED WITH OVERCROWDING IN EMERGENCY ROOM AT DOS DE MAYO NATIONAL HOSPITAL LIMA - PERU

  • Internal Medicine Master in Public Health Services Management.
  • Principal Professor of San Marcos National University, Lima, Peru.
  • Associate Professor of San Marcos National University, Lima, Peru.
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Aim: To determine associated factors related to overcrowding in the emergency room at the Dos de Mayo National Hospital. Design and Study Population: Analytical, observational, quantitative study. Variables and Measurements: Demand was determined. Times in triage, admission, medical care, auxiliary tests and stay were measured to assess the efficiency of the processes. Finally, the existing free beds in hospitalization were determined. Statistical Analysis: Bivariate analysis and multivariate logistic regression were used. P <0,05 was considered significant. Results: The average age of the patients was 48.79 (SD ? 19,50). Demand in these last two years has increased around 1.57% monthly and 18.85% annually. The total care time was 286,12 minutes ? 36.45 (4,76 hours ? 0.60). The increase in demand (input), and the deficiency of health care processes were not associated with overcrowding, according to bivariate analysis (p> 0.05). Contrary, to the output processes, were closely associated with overcrowding according to the multivariate logistic regression analysis. X2: 48.46, OR: 18.50, p: 0.00. Conclusions: The absence of available beds in hospitalization of medicine service is associated with overcrowding, it was found that the availability of less than 8 beds / day in hospitalization rooms leads to 80% overcrowding per day/ month of the emergency room.


  1. Tomas Ignacio Ponce Varillas. Hacinamiento en los servicios de emergencia. An Fac med. 2017;78(2):218-223. DOI: http://dx.doi.org/10.15381/anales.v78i2.13221
  2. Vuori HV. The principles of quality assurance. WHO Regional Office for Europe. Euro Report and Studies. 1994.
  3. Kurylo LL. Measuring inappropriate utilization. Hospital and Health Services Administration. 1976; 21:73-89.
  4. Rosser RM, Chir B. The reliability and application of clinical judgment in evaluating the use of hospital beds. Med Care. 1976; 14:39-47.
  5. Contreras C, Galarza C. Hospitalizaciones inadecuadas en emergencias m?dicas. Rev Soc Peru Med Interna 2011;24 (1):19-25.
  6. Kellerman A. Crisis in the emergency department. N Engl J Med. 2006. 28;355(13):1300-3. Disponible en: http://dx.doi.org/ DOI: 10.1056/NEJMp068194.
  7. Asplin B, Magid D, Rhodes K. A conceptual model of emergency department crowding. Ann Emerg Med. 2003; 42:173-80. Disponible en: http://dx.doi.org/ DOI: 10.1111/j.1553- 2712.2010.00814.x
  8. Contreras Camarena C. Factores asociados a hospitalizaciones inadecuadas a los servicios de medicina. Rev SocPeru Med Interna 2011;24 (4):177-85
  9. Contreras Camarena C. Utilizacion hospitalaria de las especialidades m?dicas. Acta Med Per 2011; 28(2):124-31
  10. Hoot N, Aronsky D. Systematic review of emergency department crowding causes, effects, and solutions. Ann Emerg Med. 2008;52(2):124-36. Disponible en: http://dx.doi.org/ DOI: 10.1016/j.annemergmed.2008.03.014
  11. Vasquez-Alva R, Amado-Tineo J, Ram?rez-Calderon F, Velasquez-Velasquez R, Huari-Pastrana R. Sobredemanda de atencion m?dica en el servicio de emergencia de adultos de un hospital terciario, Lima, Peru. An Fac med. 2016;77(4):379-85 / http://dx.doi.org/10.15381/anales.v77i4.12654
  12. Kellermann AL. Waiting room medicine: has it really come to this? Ann Emerg Med 2010; 56(5):468-71.
  13. Viccellio A, Santora C, Singer AJ, et al. The association between transfer of emergency department boarders to inpatient hallways and mortality: a 4-year experience. Ann Emerg Med 2009; 54(4):487-91.
  14. Garson C, Hollander JE, Rhodes KV. Emergency department patient preferences for boarding locations when hospitals are at full capacity. Ann Emerg Med 2008; 51(1):9-12.
  15. Salway RJ, Valenzuela R, Shoenberger JM, Mallon WK, Viccellio A. Congestion en el servicio de urgencia: respuestas basadas en evidencias a preguntas frecuentes. Med. Clin. Condes. 2017; 28(2) 220-227.
  16. Pines JM, Hilton JA, Weber EJ, Alkemade AJ, Al Shabanah H, Anderson PD, et al. International perspectives on emergency department crowding. AcadEmerg Med. 2011; 18:1358-70.
  17. Higginson I. Emergency department crowding. Emerg Med J. 2012; 29:437-43.
  18. Tudela P, M?dol J. La saturacion en los servicios de urgencias hospitalarios. Emergencias2015; 27:113-120.
  19. Boyle A, Beniuk K, Higginson I, Atkinson P. Emergency department crowding: time for interventions and policy evaluations. Emerg Med Int. 2012; 2012: 838610. doi: 10.1155/2012/838610. Epub 2012 Feb 7.

[Carlos Contreras Camarena, Mori Ramirez H., Reategui Guzman L., Leon Gamarra H., Hidalgo Garcia A. and Silva Valencia J (2020); FACTORS ASSOCIATED WITH OVERCROWDING IN EMERGENCY ROOM AT DOS DE MAYO NATIONAL HOSPITAL LIMA - PERU Int. J. of Adv. Res. 8 (2). 41-47] (ISSN 2320-5407). www.journalijar.com


Carlos Contreras Camarena
Dos de Mayo Hospital / San Marcos University

DOI:


Article DOI: 10.21474/IJAR01/10433       DOI URL: http://dx.doi.org/10.21474/IJAR01/10433


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