Boarding admitted patients in the emergency department for acute stroke is financially costly, according to a study published in Annals of Emergency Medicine,

Maureen M. Canellas, MD, from the University of Massachusetts TH Chan School of Medicine in Worcester, and colleagues conducted a prospective observational investigation of patients admitted through an emergency department for management of acute stroke. The cost of patient care activities was estimated during admission, and results were aggregated to estimate the total cost of boarding versus inpatient care.

The researchers found that per patient with acute stroke, the total daily cost was $1,856 and $993 for medical/surgical boarding and inpatient care, respectively, and $2,267 versus $2,165 for intensive care unit (ICU) boarding versus inpatient care. When accounting for costs associated with traveler nurses, these differences were even greater.

Emergency department and inpatient nurses spent 293 and 313 minutes/day, respectively, for each medical/surgical boarder and inpatient, and 419 and 787 minutes/day for each ICU boarder and inpatient, respectively. For each medical/surgery boarder versus inpatient, neurology attendings and residents spent 25 and 52 minutes/day versus 62 and 90 minutes/day, respectively.

“Our investigation provides evidence that boarding admitted patients in emergency departments, in addition to known negative quality and safety implications, is financially costly, providing added incentive and urgency for the elimination of boarding,” the authors write.

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