Table 2 Policy targets to reduce patient crowding in ED and IM departments
From: Mixed effect of increasing outflow of medical patients from an emergency department
1 | Promotion of nursing home personnel to treat common clinical conditions that currently require transfer to hospitals |
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2 | Increase bed availability in long-term care facilities |
3 | Increase hospitalization-at-home programs, both for the low-risk patients in the ED, and chronically ill IM patients awaiting a long-term care facility bed |
4 | Increase reimbursement for IM beds |
5 | Adjust bed numbers to mirror the increase of aged and dependent patients |
6 | Consider co-payment for patients, proxies, or nursing homes for unreasonable delays in discharge or demands for unsupported medical interventions (e.g., mechanical ventilation for the terminally ill or percutaneous endoscopic gastrostomy tube to prevent aspiration) |
7 | Utilize diagnostic related group-based reimbursement for IM admissions |