Emergency department overcrowding in Florida, New York, and Texas

Background. This study was done to determine the incidence, causes, and effects of overcrowding in emergency departments (EDs) in Florida, New York, and Texas. Methods. Surveys were mailed to a random sample of EDs in Florida, New York, and Texas. Questions included census, area population, frequency and causes of overcrowding, and impact. Causes of overcrowding were ranked on a 5-point scale. Results. A total of 300 surveys were sent, and 210 (70%) were returned. Overcrowding was reported in 194 EDs (92%): New York (90%), Florida, (92%), and Texas (95%). Causes of ED overcrowding included hospital bed shortage, high medical acuity of patients, increasing patient volume, too few examination spaces, and shortage of RN staff. Overcrowding resulted in death, permanent disability, additional procedures, and increased length of hospitalization. Conclusion. In this survey of EDs, overcrowding was pervasive. Many factors contribute to ED overcrowding. Poor medical outcomes may occur because of overcrowding.