Overcrowding in Emergency Departments: A Scoping Literature Review

Authors : Mustafa Altun, Emre Kudu

Pages : 94-100

Doi:10.54996/anatolianjem.1684632

View : 113 | Download : 135

Publication Date : 2025-06-26

Article Type : Review Paper

Abstract :Emergency department (ED) overcrowding occurs when healthcare demand exceeds available resources, significantly impairing the quality of patient care and the efficiency of the healthcare system. This review comprehensively analyzes the definition, causes, measurement methods, consequences, and proposed solutions of ED overcrowding. ED crowding is marked by prolonged waiting times, disrupted patient flow, interrupted medical service delivery, and risks to patient and staff safety. Patient-related factors include the preference for EDs for non-emergent conditions, complicated health issues in the elderly, low health literacy, and frequent visits by individuals with chronic illnesses. Systemic factors involve access block, staff shortages, inefficiencies in discharge processes, and delays in diagnostic tests and consultations. External factors include inadequate primary care services, socioeconomic disparities, seasonal fluctuations, epidemics, and natural disasters. To evaluate ED crowding, measurement tools such as the National Emergency Department Overcrowding Scale and the Emergency Department Work Index are utilized; however, the lack of standardization and variability across different hospital types remains a point of contention. Overcrowding compromises patient safety, leading to treatment delays, increased medical errors, staff burnout, and escalating healthcare costs. Proposed solutions include short-term measures (fast-track units, early discharge planning, patient redirection), long-term strategies (enhancing primary care, establishment of acute care centers, management of inpatient bed capacity, and planning to reduce the burden of chronic illnesses), and technological approaches (artificial intelligence, simulation models, telemedicine, and patient tracking technologies). Gaps in the literature include issues related to the validity and reliability of measurement tools, limited data on the economic and clinical impacts of interventions, insufficient research in low- and middle-income countries, and inadequate examination of patient behaviors and the psychological effects on healthcare personnel. The effective management of ED crowding requires the coordinated implementation of systemic reforms, innovative technologies, and collaborative efforts across clinical, academic, and policy-making domains. This is a critical step toward enhancing patient safety, improving clinical outcomes, and ensuring the sustainability of the healthcare system.
Keywords : Yatış bloğu, acil servis, kalabalıklık, hasta akışı

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