Managing access block involves reducing hospital demand and optimising bed capacity
Hospital overcrowding causing “access block” — a lack of available inpatient beds for emergency department patients — remains a major impediment to the delivery of good health care both in Australia and overseas. It is obvious that making elderly or disabled patients wait on uncomfortable emergency trolleys in corridors, with sleep deprivation and minimal privacy, is inhumane. Previous research has shown that hospital overcrowding is actually inefficient: it is associated with increased length of hospital stay,1,2 thus potentially reducing throughput. The number of adverse events has also been shown to increase with worsening access block.3,4
The full article is accessible to AMA members and paid subscribers. Login to read more or purchase a subscription now.
Please note: institutional and Research4Life access to the MJA is now provided through Wiley Online Library.
- Epidemiology and Preventive Medicine, Monash University, Prahran, VIC.
- 1. Liew D, Liew D, Kennedy MP. Emergency department length of stay independently predicts excess inpatients length of stay. Med J Aust 2003; 179: 524-526. <MJA full text>
- 2. Richardson DB. The access block effect: relationship between delay to reaching an inpatient bed and inpatient length of stay. Med J Aust 2002; 177: 492-495. <MJA full text>
- 3. Fernandes CM. Emergency department overcrowding: what is our response to the “new normal”? Acad Emerg Med 2003; 10: 1096-1097.
- 4. Miro O, Antonio MT, Jimenez S, et al. Decreased health care quality associated with emergency department overcrowding. Eur J Emerg Med 1999; 6: 105-107.
- 5. Sprivulis PC, Da Silva J-A, Jacobs IG, et al. The association between hospital overcrowding and mortality among patients admitted via Western Australian emergency departments. Med J Aust 2006; 184: 208-212.
- 6. Richardson DB. Increase in patient mortality at 10 days associated with emergency department overcrowding. Med J Aust 2006; 184: 213-216.
- 7. Cameron PA, Campbell D. Access block: problems and progress. Med J Aust 2003; 178: 99-100. <MJA full text>
- 8. National Health Service Modernisation Agency. Available at: http://www.wise.nhs.uk/cmswise/default.htm (accessed Dec 2005).
- 9. Australian Institute of Health and Welfare. Total health expenditure. Available at: http://www.aihw.gov.au/publications/hwe/hea03-04/hea03-04-c02.pdf (accessed Dec 2005).
- 10. Auditor General Victoria. Managing emergency demand in public hospitals. Melbourne: Auditor General’s Office, May 2004.