Efficient utilization of the limited number of emergency medicine specialists and statistics related to clinical outcomes in the emergency department.

Abstract

ObjectiveThe supply of emergency medicine (EM) specialists has not been able to meet demand in the past decade. This study comparatively analyzed clinical findings to provide fundamental data to inform efficient utilization of a limited number of EM specialists.MethodsThis retrospective study included 54,204 patients who visited the emergency department of a tertiary care medical center from March 1 to December 31, 2012. The experimental specialist-supervised (SS) group included patients supervised by an EM specialist, while the control specialist-on-call (SOC) group included patients attended by a senior resident of EM with an EM specialist on call.ResultsThe mean length of stay in the emergency department was longer in the SS group than in the SOC group for all levels of severe-to-moderate (levels 1 to 3) and mild (levels 4 and 5) patient conditions (P<0.05). The mortality rate of severe-to-moderate patients in the SOC group was 1.63 times higher than that in patient in the SS group.ConclusionSupervision by EM specialists significantly decreased mortality in patients with severe-to-moderate condition. Therefore, EM specialists should focus on this patient group, while training residents should concentrate on patients with relatively mild conditions.