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[Lack of inhospital beds: impact on emergency department performance].

BACKGROUND AND OBJECTIVE
To determine the effect that the lack of inhospital beds exerts on emergency department performance.


MATERIAL AND METHOD
Two different time periods with comparable daily census, but significantly different bed availability. Variables assessed were general emergency department performance markers, emergency department effectiveness markers and objective and subjective quality markers.


RESULTS
All variables got worse within lower bed availability period, and reached a change magnitude between 0% and 300% when compared with control period. However, a statistical difference was only achieved in emergency department occupation rate (+14%; p < 0.001), rate of patients waiting to be admitted (+100%; p < 0.001), patients waiting to be seen (+60%; p < 0.01), waiting time to be seen (+83%; p < 0.001), time to employed for first medical assessment and treatment (+44%; p < 0.01), and patients left without being seen (+90%; p < 0.05).


CONCLUSIONS
The lack of inhospital beds for patients admitted from the emergency department leads to a remarkable worsening in its function and performance.