A Novel Pilot Program Using Patient Incentives to Address Emergency Department Boarding and Overcrowding: A Retrospective Observational Study.

IF 3.2 3区医学 Q1 EMERGENCY MEDICINE

Academic Emergency Medicine Pub Date : 2026-06-01 DOI:10.1111/acem.70359

Nancy Glober, Diane Kuhn, Lisa Martin, Lauren Stewart, Pam Tanner-Lauderbaugh, John Sparzo, Michele McCarroll

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引用次数: 0

Abstract

Background: Emergency department (ED) overcrowding is a routine challenge for most hub hospitals, reported by more than 90% of ED medical directors several times each week. Alternate treatment locations are permissible within the Emergency Medical Treatment and Labor Act (EMTALA) regulations (with patient consent) as long as hospitals screen and stabilize any patient presenting to an ED.

Methods: This pilot study explored the feasibility and patient acceptability of offering financial compensation to low-acuity patients who agreed to transfer from an overcrowded ED to critical access hospitals.

Results: Four eligible patients requiring medical-surgical admission participated. Transfers included travel vouchers of $300-$500. All transfers were completed safely without retransfer or complications, and all patients were discharged home. The aggregate Net Promoter Score was +75, indicating strong satisfaction.

Conclusions: Findings suggest that modest financial incentives may support patient-approved interfacility transfers, ease ED overcrowding, and enhance utilization of underused hospitals while complying with EMTALA. Further study of this model is warranted.

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一项利用患者激励解决急诊科住院和过度拥挤问题的新颖试点计划：一项回顾性观察研究。

背景：急诊科（ED）人满为患是大多数中心医院的常规挑战，90%以上的急诊科医学主任每周都会报告几次。根据《紧急医疗和劳工法》（EMTALA）规定（经患者同意），只要医院对任何到急诊科就诊的患者进行筛查和稳定，其他治疗地点是允许的。方法：本试点研究探讨了向同意从拥挤的急诊科转到危重医院的低视力患者提供经济补偿的可行性和患者可接受性。结果：有4例符合条件的住院患者参与。转帐包括300至500美元的旅行代金券。所有转移均安全完成，无再转移或并发症，所有患者均出院回家。总净推荐值为+75，表明满意度很高。结论：研究结果表明，适度的财政激励可以支持患者批准的设施间转移，缓解急诊科过度拥挤，并在遵守EMTALA的同时提高未充分利用医院的利用率。对这一模型的进一步研究是有必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Academic Emergency Medicine 医学-急救医学

CiteScore

7.60

自引率

6.80%

发文量

207

审稿时长

3-8 weeks

期刊介绍： Academic Emergency Medicine (AEM) is the official monthly publication of the Society for Academic Emergency Medicine (SAEM) and publishes information relevant to the practice, educational advancements, and investigation of emergency medicine. It is the second-largest peer-reviewed scientific journal in the specialty of emergency medicine. The goal of AEM is to advance the science, education, and clinical practice of emergency medicine, to serve as a voice for the academic emergency medicine community, and to promote SAEM''s goals and objectives. Members and non-members worldwide depend on this journal for translational medicine relevant to emergency medicine, as well as for clinical news, case studies and more. Each issue contains information relevant to the research, educational advancements, and practice in emergency medicine. Subject matter is diverse, including preclinical studies, clinical topics, health policy, and educational methods. The research of SAEM members contributes significantly to the scientific content and development of the journal.