Annals of Emergency Medicine
Volume 54, Issue 4 , Pages 492-503.e4 , October 2009

Crowding Delays Treatment and Lengthens Emergency Department Length of Stay, Even Among High-Acuity Patients

  • Melissa L. McCarthy, ScD

      Affiliations

    • Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
    • Corresponding Author InformationAddress for reprints: Melissa L. McCarthy, ScD, 5801 Smith Avenue, Davis Building Suite 3220, Department of Emergency Medicine, Baltimore, MD 21209; 410-735-6421, fax 410-735-6425
    • ,
  • Scott L. Zeger, PhD

      Affiliations

    • Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
    • ,
  • Ru Ding, MS

      Affiliations

    • Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
    • ,
  • Scott R. Levin, PhD

      Affiliations

    • Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
    • ,
  • Jeffrey S. Desmond, MD

      Affiliations

    • Department of Emergency Medicine, University of Michigan School of Medicine, Ann Arbor, MI
    • ,
  • Jennifer Lee, MD

      Affiliations

    • Department of Emergency Medicine, George Washington University School of Medicine, Washington, DC
    • ,
  • Dominik Aronsky, MD, PhD

      Affiliations

    • Department of Biomedical Informatics and the Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN

Received 14 January 2009 ,Revised 25 February 2009 ,Accepted 3 March 2009.

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 Provide feedback on this article at the journal's Web site, www.annemergmed.com.

 Supervising editor: Donald M. Yealy, MD

 Author contributions: All of the authors were involved in the study concept and design, drafting of the article, and critical revision of the article for important intellectual content. The objectives, data collection protocol, review of the analysis, and findings were discussed by teleconference calls with all of the investigators. MLM, JSD, JL, and DA were responsible for acquiring the data from their sites and obtaining institutional review board approval. RD performed the data analysis under the supervision of MLM and SLZ. However, all of the authors had input into the variables considered for the analysis and how it was conducted. MLM drafted the article, and all authors contributed substantially to its revision. MLM takes responsibility for the paper as a whole.

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.

 Earn CME Credit: Continuing Medical Education is available for this article at: www.ACEP-EMedHome.com.

 Publication date: Available online May 6, 2009.

PII: S0196-0644(09)00239-X

doi: 10.1016/j.annemergmed.2009.03.006

Annals of Emergency Medicine
Volume 54, Issue 4 , Pages 492-503.e4 , October 2009

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