Funding outcome

Emergency Department (ED) crowding is a major problem in the Canadian health care system and has become one of the most important issues in health care delivery. ED overcrowding has been linked to delays of time-sensitive interventions (e.g ., administration of pain medications, treatment of stroke and heart attacks), poor patient outcomes, patients leaving without completing care, patient and staff dissatisfaction, and increased health care spending. More importantly, ED overcrowding has been shown to increase the risk of patient deaths and decrease quality of care, especially when hospitals have high occupancy and physician assessment is delayed. Obstructive lung diseases such as asthma are ambulatory-care sensitive conditions that require prompt and appropriate care in the ED. In Canada, we have little evidence on how ED crowding impacts quality of care and health outcomes in patients with these conditions. This project will use administrative health data to analyze all ED visits for asthma made by children aged 2 to 17 in 18 high-volume EDs in Alberta from 2002 to 2015. Measures of ED crowding (wait time, time to physician assessment, time in ED) will be calculated for each ED. For children with asthma who visit an ED, we will examine the impact of measured ED crowding on their care and outcomes such as time in the ED, admission to hospital and time spent there, physician follow-up, and return to ED. We hypothesize that ED crowding has increased over time and varies by facility and geography. We expect that longer wait times and ED lengths of stay will be associated with more hospitalizations and shorter times to ED return. This study will be a novel examination of the impact of ED crowding on patient outcomes in a respiratory condition that carries a significant burden for the health system, patients, and society. Results of this study are important for patients, health providers and health administrators to further understand the negative consequences of ED crowding on health outcomes. Our findings can encourage patient-oriented interventions aimed at reducing the impact of ED crowding for children with asthma.