Translated Titles

Emergency department overcrowding: an overview of critical issues and improvement strategies




蔡哲宏(Jeffrey Che-Hung Tsai);蔡耀德(Yao-Te Tsai);翁紹仁(Shao-Jen Weng);劉士嘉(Shih-Chia Liu)

Key Words

急診 ; 壅塞 ; 醫療品質 ; 病人安全 ; emergency department ; crowding ; medical quality ; patient safety



Volume or Term/Year and Month of Publication

40卷1期(2021 / 02 / 26)

Page #

8 - 29

Content Language


Chinese Abstract


English Abstract

This study reviews emergency department (ED) crowding by focusing on the current situations in Taiwan, causes and mechanisms, the impact of ED crowding on health care quality, and improvement strategies. We searched studies addressing ED crowding between 1999 and 2019 and summarized the most representative articles. We found that the input-throughput-output model can help analyze the causes and effects of ED crowding and reveal potential solutions. ED patients must compete for medical resources, such as acute care beds, with non-ED patients, and reservoir level has been used to explain the mechanism of ED crowding. ED crowding stems from multiple complex factors, mainly including output factors, hospital operation systems, and the health care system overall. The indicators of ED crowding are prolonged waiting time and a crowded space. The number of patients in the ED is indirectly correlated with the ED occupancy rate, and is useful to reflect the situation of crowding. Strategies to solve ED crowding include changes in ED operations and hospital management and the use of a community network. ED crowding has been a critical issue for hospitals, and changes in the health care environment and operations have exacerbated this problem; every staff member has to expend considerable effort in dealing with it. Financial pressure might prevent decision-makers from implementing potential solutions; therefore, incentives and government support may be required. We hope that this study provides a useful overview for researchers and policymakers and guides them to make effective policies for addressing ED crowding.

Topic Category 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學