Washington, DC - Patients who come to emergency departments with minor conditions do not contribute significantly to delays and overcrowding, despite widely held beliefs to the contrary, according to a new study to be published online in the Annals of Emergency Medicine ("The Effect of Low-Complexity Patients on Emergency Department Waiting Times"). 

"Our research shows that caring for patients with minor ailments [or low-complexity patients] does not lead to longer delays or slower care for other, sicker patients," said study author Dr. Michael J. Schull of the Institute for Clinical Evaluative Sciences in Toronto, Canada. "We already know that it is delays in the care of sicker patients, especially those who require hospital admission, that lead to worsened crowding.  Therefore our study suggests that low-complexity patients are not a key contributor to overcrowding."
 
Over a one-year period (April 2002 to March 2003), Dr. Schull and his team studied 4.1 million patient visits at 110 emergency departments in Ontario hospitals.  They found that every 10 patients with minor ailments arriving in any eight-hour period added only 5.4 minutes on average to the length-of-stay and 2.1 minutes on average to the time spent waiting to see the doctor for patients with more serious medical problems. 

"These delays are not clinically important, and have a negligible effect on the overall waiting time of other emergency department patients," said Dr. Schull. "While low-complexity patients represent half of all patients seen in community and teaching hospital emergency departments in Ontario, they do not have a substantial impact on the efficiency or timeliness of care given to other, more acutely ill, emergency department patients."

The study suggests that reducing the number of low-complexity patients in emergency departments would do little to reduce emergency department delays for sicker patients, and hence do little to reduce crowding.  One likely explanation is that most patients with minor ailments or injuries are not usually placed in the treatment spaces used for sicker patients.  In addition, the resources they require are generally simple and readily available, and staff allocate time to these patients in lower priority than they do for sicker patients.

"Dr. Schull's study shows yet again that patients using the emergency department - even those with relatively minor illnesses or injuries - are not to blame for emergency department overcrowding.  Our broken health care system is," said Dr. Frederick C. Blum, president of the American College of Emergency Physicians.

Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, a national medical society with more than 23,000 members. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.

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