No difference in safety-net length of stay

Despite arguments that safety-net emergency departments are at an inherit disadvantage, a new Journal of the American Medical Association study found that there's little difference in length of stay between safety-net hospitals and non-safety nets.

"Although concerns have been raised that performance measures, particularly those linked to payment, may ultimately penalize safety-net institutions that are already underfunded and that care for a disproportionate volume of patients with poorer health care status, our findings suggest that those concerns about ED length of stay will not penalize safety-net institutions," the authors wrote, according to a JAMA press release yesterday.

The study did confirm that patients treated at safety-net EDs were more likely to be young and minority than those treated at non-safety-net EDs, and were less likely to need emergency or urgent care in both admitted and discharged populations.

However, the study could suggest that safety-net EDs aren't predisposed to disadvantages and shouldn't use their population mix as an excuse in failing to meet performance measures, such as length-of-stay targets.

Researchers found that median ED length of stay was 269 minutes for safety-net EDs, only 12 minutes shorter than 281 minutes for non-safety-net EDs.

In critical care admissions--which made up 12.5 percent of all safety-net admissions and 13.2 percent in non-safety-nets-- the median ED length of stay was 236 minutes, compared to 248 minutes, respectively. For discharged patients, the median ED length of stay was 156 minutes versus 148 minutes, 355 minutes for observations versus 298 minutes, and 235 minutes for transfers versus 239 minutes.

The study pointed out that compliance with proposed ED length-of-stay measures for admissions, discharges, transfers and observations did not differ significantly between safety-net and non-safety-net hospitals.

For more information:
- read the study abstract
- here's the press release

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