Original contributionDemand on ED resources during periods of widespread influenza activity
Section snippets
Study design
An observational analysis of secondary data was obtained from a computerized ED patient log over a 130-week period.
Study setting
We studied an urban level-one trauma center with a 32-bed ED and an annual patient census of approximately 68,000 during the study period. The institution is a private, 877-bed, not-for-profit teaching hospital located in western Los Angeles County. The catchment area for the hospital has a lower- to upper-income population of approximately 550,000. The major ethnic groups
Results
The study period, from October 1997 through March 2000, included 34 weeks of CDC designated WIA occurring in 3 distinct time periods (Fig. 1). Period I spanned 12 weeks, beginning week 51 of 1997 and ending week 10 of 1998.3 Period II spanned 14 weeks beginning week 1 of 1999 and ending week 14 of 1999.4 Period III spanned 8 weeks, beginning week 50 of 1999 and ending week 5 of 2000.5
Overall, the ED’s census increased throughout the entire study period independent of WIA. There was no
Discussion
Influenza annually affects thousands of individuals from all segments of the population.2, 5, 6, 7, 8, 9, 10, 11, 12 The primary objective of this study was to investigate the relationship between periods of WIA and ED resource demand. We found WIA to be associated with recurrent and predictable changes in markers of resource utilization in our ED, with the most significant changes occurring during the initial weeks of each episode. Increases were seen in the time patients spent in the ED, the
Conclusions
We found an association between WIA and increased ED resource demand. Several markers we used to measure this demand were elevated during periods of WIA, including increases in time patients spent in the ED, the number of inpatient admissions, the number of LWBS patients, and the amount of time the ED was closed as a result of saturation.
A spike in ED patient census was found at the start of each period of WIA. We also discovered an association between periods of WIA and the flu index. This
Acknowledgements
The authors thank Cindy Balin, RN, for her help with data collection and Mendel Roth for his help with manuscript preparation.
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