The effect of the emergency department deciding to admit patients to internal medicine to resolve overcrowding in emergency medical centers in South Korea

Objective: The aim of this study was to evaluate the usefulness of decision-making for admitting patients to the Department of Internal Medicine (DIM) by the emergency department as a strategy to resolve overcrowding in emergency medical centers (EMCs).Methods: This retrospective study was conducted at an EMC during two periods: January 1, 2019, to December 31, 2019, and March 1, 2023, to February 29, 2024.In total, 10,164 patients in the pre-intervention period and 11,409 patients in the post-intervention period (PoIP) (aged 18 years) were included.Sex, age, the time interval from the EMC visit to departure, Korean Triage and Acuity Scale (KTAS) scores, and severity of illness diagnosis codes were compared between the two groups.Results: The time interval from the EMC visit to departure for patients admitted to the DIM significantly decreased in the PoIP.The time interval from the EMC visit to departure for patients with KTAS 1-3 and for patients diagnosed with severe illness also significantly decreased during the PoIP.Conclusion: Issuing admission orders to the DIM directly from the emergency department is useful for reducing length of stay and alleviating overcrowding in EMCs.