Rural-urban differences in emergency department wait times

Introduction: I sought to determine whether emergency department (ED) volume is associated with differing ED wait times. Methods: I conducted a retrospective analysis of the Emergency Department Reporting System database of the Ontario Ministry of Health. I abstracted ED length of stay for patient visits to 117 hospital EDs during the second quarter of 2008, representing 89% of ED visits in the province during that period. Annual volume of ED visits, lengths of stay in the ED and acuity levels of patients were measured. Results: All EDs were more efficient in managing the treatment of low-acuity patients compared with high-acuity patients. Small rural EDs in Ontario had the shortest wait times for both high-and low-acuity patients (medians 2.35 h for high-acuity and 1.46 h for low-acuity patients in small rural EDs v. 4.98 h for high-acuity and 2.85 h for lowacuity patients in teaching hospitals). Conclusion: Among the hospitals studied, rural EDs had the shortest wait times for both low-and high-acuity patients.