2023 14th Annual NUBE Conference

Background: Despite increasing numbers of psychiatric patients being boarded in the emergency department (ED) for extended periods of time, studies show that these patients rarely receive optimal therapeutic treatment, resulting in decreased bed turnover and increased costs for hospital systems. This study aims to quantify disparities in variables denoting length of stay (LOS) for psychiatric patients and nonpsychiatric patients in EDs. The authors used retrospective chart review to evaluated psychiatric and nonpsychiatric adult admissions in several EDs in Connecticut, considering different measures of LOS. 779 psychiatric patients and 57,949 nonpsychiatric patients were considered. Time to be seen by Physician (37.69 minutes vs 28.65 minutes, P<0.001) and time between arrival and discharge (1174.78 minutes vs 332.87 minutes, P<0.001) were both significantly longer for patients housed in psychiatric sites. Time in waiting room is notably significantly shorter for psychiatric patients (9.46 minutes vs 15.93 minutes, P<0.001). All disparities are found to be highly statistically significant and the time between arrival and discharge is clinically significant as well, amounting to about a 14 hour difference between psychiatric and nonpsychiatric patients.

Learning Objectives:

1. Review current knowledge of discrepancies in care for psychiatric patients in the emergency department.2. 
2. Describe the differences in measures of length of stay for psychiatric patients versus nonpsychiatric patients.
3. Discuss the implications of the discrepancies and consider how reallocation of resources in the emergency department can improve care for all patients.