The Economics of an Admissions Holding Unit

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" The Economics of an Admissions Holding Unit "
Schreyer, Kraftin E.; Martin, Richard

Document Type	:	AL
Record Number	:	933121
Doc. No	:	LA9b74r64q
Language of Document	:	English
Main Entry	:	Schreyer, Kraftin E.; Martin, Richard
Title & Author	:	The Economics of an Admissions Holding Unit [Article]\ Schreyer, Kraftin E.; Martin, Richard
Title of Periodical	:	Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health
Volume/ Issue Number	:	18/4
Date	:	2017
Abstract	:	Introduction: With increasing attention to the actual cost of delivering care, return-on-investment calculations take on new significance. Boarded patients in the emergency department (ED) are harmful to clinical care and have significant financial opportunity costs. We hypothesize that investment in an admissions holding unit for admitted ED patients not only captures opportunity cost but also significantly lowers direct cost of care.Methods: This was a three-phase study at a busy urban teaching center with significant walkout rate. We first determined the true cost of maintaining a staffed ED bed for one patient-hour and compared it to alternative settings. The opportunity cost for patients leaving without being seen was then conservatively estimated. Lastly, a convenience sample of admitted patients boarding in the ED was observed continuously from one hour after decision-to-admit until physical departure from the ED to capture a record of every interaction with a nurse or physician.Results: Personnel costs per patient bed-hour were