ABSTRACT
STUDY OBJECTIVE: Taking advantage of a medical student strike, the authors evaluated the effect of medical students on emergency department length of stay (LOS). METHODS: ED LOS and patient characteristics were compared for the 4-day strike period and the same days the week before. Proportions were compared by using the Mann-Whitney U test and the chi(2) test (P <.05). RESULTS: Eight hundred thirty-one patients were studied. There was no significant difference between the study and control periods for the general patient characteristics or laboratory or radiologic investigations. Median LOS decreased by 24% (31 minutes, 95% confidence interval [CI] 24 to 38) during the strike (110 minutes [95% CI 65 to 178] to 79 minutes [95% CI 40 to 135], P <10(-4)). CONCLUSION: Medical students lengthen ED LOS. This should be explained to patients and should be considered as one justification for increasing medical staff in the teaching ED.
Subject(s)
Emergency Service, Hospital/statistics & numerical data , Length of Stay/statistics & numerical data , Students, Medical/statistics & numerical data , Adult , Efficiency , Female , France , Hospitals, University , Humans , Male , Time and Motion StudiesABSTRACT
This prospective study compared the prescriptions of biological tests (PBT) for patients admitted to an Emergency medical service (EMS) of a University hospital, according as to whether the staff consisted either of medical residents only (study period P1) or of residents trained in emergency medicine and continuously supervised by a senior specialist (study period P2). During the one-month study periods, a total of 5,948 patients were admitted (2,781 during P1 and 3,167 during P2 respectively). Between P1 and P2 the rate of PBT decreased by 38.8% (P < 0.0001), the mean expenses for PBT per patient by 13.8% (P < 0.0001) and the total expenses by 53.4%. Teaching and training of residents in emergency medicine and supervision by a senior specialist improve the quality of care and decrease health care cost.
