• Thomas Falvo, Lance Grove, Ruth Stachura, and William Zirkin.
• Health Services Design Section, Department of Emergency Medicine, York Hospital, WellSpan Health System, York, PA, USA. tfalvo@wellspan.org
• Acad Emerg Med. 2007 Jan 1;14(1):58-62.

ObjectivesAdmission process delays and other throughput inefficiencies are a leading cause of emergency department (ED) overcrowding, ambulance diversion, and patient elopements. Hospital capacity constraints reduce the number of treatment beds available to provide revenue-generating patient services. The objective of this study was to develop a practical method for quantifying the revenues that are potentially lost as a result of patient elopements and ambulance diversion.MethodsHistorical data from 62,588 patient visits to the ED of a 450-bed nonprofit community teaching hospital in central Pennsylvania between July 2004 and June 2005 were used to estimate the value of potential patient visits foregone as a result of ambulance diversion and patients leaving the ED without treatment.ResultsThe study hospital may have lost 3,881,506 dollars in net revenue as a result of ambulance diversions and patient elopements from the ED during a 12-month period.ConclusionsSignificant revenue may be foregone as a result of throughput delays that prevent the ED from utilizing its existing bed capacity for additional patient visits.

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