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The following is a summary of “Short-Stay Hospitalizations and Hospital Capacity Constraints,” published in the April 2025 issue of Annals of Emergency Medicine by Janke et al. 

Researchers conducted a retrospective study to describe how short-stay hospitalizations contributed to hospital capacity constraints and emergency department (ED) crowding.  

They analyzed hospitalizations across 4 US EDs (January 2018 to June 2024) and calculated total occupancy hours by subtracting the hospital departure time from the ED disposition timestamp. The short stays were defined as hospitalizations lasting 48 hours or less, including hospital-based observation stays and reported the proportion of short stays as a percentage of total ED-related hospital occupancy hours and quantified total boarding time in the ED by cumulative hours.  

The results showed 6,25,233 hospitalizations occurred across 21,47,525 ED visits at 4 sites, accounting for 85,508,996 total hospital occupancy hours. Short-stay hospitalizations, defined as 48 hours or less, comprised 33.6% of ED-related hospitalizations. Between 2018 and 2024, the proportion of short-stay ED hospitalizations declined significantly (annualized percent change −1.2% [95% CI −2.0% to −0.4%]), while the share of total hospital occupancy hours showed no significant change (−0.4% [95% CI −0.9% to 0%]). Boarding time in the ED increased over the study period (+0.6% [95% CI 0.3% to 0.9%]). Overall (OA), short stays accounted for 7.6% of total in-hospital occupancy hours tied to ED hospitalizations.  

Investigators concluded that short-stay hospitalizations comprised a small fraction of ED-related hospital occupancy hours and did not explain increasing hospital boarding in the ED, suggesting that targeting them would have had little OA impact on mitigating acute care capacity constraints. 

Source: annemergmed.com/article/S0196-0644(25)00140-4/abstract