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March 25, 1992

Hospital Admission Through the Emergency Department

Author Affiliations

University of California, Irvine Orange

JAMA. 1992;267(12):1609-1610. doi:10.1001/jama.1992.03480120047017

To the Editor.  —In their article on ED admissions, Stern et al1 found that, even after adjusting for diagnosis related group severity and socioeconomic status, patients admitted through the ED stayed 27% longer and incurred 13% higher charges than other patients.An additional important variable to consider is delay in seeking care prior to hospitalization. Another study by Weissman et al2 found that hospitalized patients who reported a delay had a 9% longer hospital stay compared with others. In a study of ED admissions at our teaching hospital,3 patients admitted through the ED who initially delayed seeking care had markedly (approximately 25%) longer lengths of stay and higher hospital charges than patients in the ED who did not delay.The overriding message from these studies is that patients admitted via the ED often use more health care resources than do other patients. The key underlying factors include