National Reporting of Emergency Department Length of Stay:  Challenges, Opportunities, and Risks

In this issue of JAMA, Fee and colleagues¹ report data from the 2008 National Hospital Ambulatory Medical Care Survey evaluating the ability of emergency departments at safety-net hospitals to comply with parameters for time to disposition for both admitted and discharged patients. Based on analysis of nearly 25 000 patient visits, including 11 065 visits at safety-net hospitals and 13 654 visits to non–safety-net emergency departments, there were no significant differences for compliance with proposed length-of-stay measures for admitted patients (median, 269 minutes vs 281 minutes) or discharged patients (median, 156 minutes vs 148 minutes) for safety-net emergency departments and non–safety-net emergency departments, respectively. However, there were associations between longer emergency department length of stay and several subgroups examined, including patients of nonwhite race, those with lower triage acuity, and type of treating clinician (eg, resident/intern).