Factors Associated with Occupancy Level in a High- Complexity Emergency Department in Medellín

Abstract

Introduction: Emergency department (ED) occupancy is influenced by multiple factors, with overcrowding becoming increasingly prevalent. This complex phenomenon is challenging to be measured and negatively impacts patient care delivery. Objectives: To determine the ED occupancy level at Hospital Pablo Tobón Uribe, Medellin, using the National Emergency Department Overcrowding Study (NEDOCS), analyzing hospital service factors, processes, physical capacity, and human resources. Methods: An analytical cross-sectional study was conducted. ED occupancy levels were measured continuously over two weeks. Statistical analysis included univariate, bivariate (Chi-square and Spearman correlation), and multivariate (multiple linear regression) analyses. Results: NEDOCS indicated dangerously overcrowded conditions 98.2% of the time. Correlation between the emergency physician’s perception and NEDOCS scores showed p=0.526. Multivariate model revealed associations with total ED patients (p=0.427), total patients in resuscitation area (p=0.436), and total ED-admitted patients (p<0.01), with an adjusted R2 of 23%. Conclusions: ED occupancy levels remained dangerously overcrowded du­ring most of the study period. Development of an explanatory model for factors associated with ED occupancy levels was precluded by the constant nature of the outcome variable.

Keywords

• bed occupancy
• emergencies
• emergency service hospital