“Bigger hospitals with more visits tend to have worse flow and longer wait times either because of the complexity of their patient loads or because managing flow in larger urban hospitals is more of a challenge,” Dr. Jesse Pines, associate professor of emergency medicine and health policy at George Washington University, Washington, and lead author of the study, said in a news release.
Publicly reporting emergency throughput data without adjusting for factors such as case mix and region could potentially punish high-volume hospitals even if they are performing well within their peer group, the authors argued.
Emergency departments with more than 60,000 annual visits had median wait times that were 25 minutes longer than EDs with 20,000 fewer annual visits, according to the study.
“Looking at the raw times, a patient might choose a smaller, rural hospital with shorter waits without considering that certain hospitals might not be the best for their particular emergency,” Pines said in the release. “What ultimately may be needed is either a way for patients to compare waiting times in similar hospitals or an explanation of why waiting times or (lengths of stay) just tends to be longer in certain hospitals. This will give people a more accurate picture of which hospitals are doing well and why.”