The effects of publishing emergency department wait time on patient utilization patterns in a community with two emergency department sites: a retrospective, quasi-experiment design

Bin Xie,Sabrina Youash

doi:10.1186/1865-1380-4-29

Abstract

BackgroundProviding emergency department (ED) wait time information to the public has been suggested as a mechanism to reduce lengthy ED wait times (by enabling patients to select the ED site with shorter wait time), but the effects of such a program have not been evaluated. We evaluated the effects of such a program in a community with two ED sites.MethodsDescriptive statistics for wait times of the two sites before and after the publication of wait time information were used to evaluate the effects of the publication of wait time information on wait times. Multivariate logistical regression was used to test whether or not individual patients used published wait time to decide which site to visit.ResultsWe found that the rates of wait times exceeding 4 h, and the 95th percentile of wait times in the two sites decreased after the publication of wait time information, even though the average wait times experienced a slight increase. We also found that after controlling for other factors, the site with shorter wait time had a higher likelihood of being selected after the publication of wait time information, but there was no such relationship before the publication.ConclusionsThese findings were consistent with the hypothesis that the publication of wait time information leads to patients selecting the site with shorter wait time. While publishing ED wait time information did not improve average wait time, it reduced the rates of lengthy wait times.

Highlights

Providing emergency department (ED) wait time information to the public has been suggested as a mechanism to reduce lengthy ED wait times, but the effects of such a program have not been evaluated
We aim to test the hypothesis that publication of wait time information would lead to more patients visiting the ED site with shorter published wait time, and that such a change in utilization pattern would lead to reduction in lengthy wait times in a community with two ED sites
It can be seen that the rates of wait times exceeding 4 h and the 95th percentile of the wait times in both sites had a statistically significant decrease after the intervention, even though the average wait times slightly increased in both sites

Summary

Introduction

Patients are known to be willing to travel or to switch healthcare providers in order to achieve shorter wait times [9,10,11,12,13,14], and if more patients choose providers with shorter wait times, lengthy wait times might be less likely to occur. Such effects, have not been empirically demonstrated. Wait times in different ED sites in the same community can differ significant [8,19,20], and patients’ selection of providers is less constrained by factors such as referral, continuity of care, and familiarity with providers, as patients usually do not require a referral to visit an ED, and patients usually do not have the ability to select care providers in an ED

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