Using admission from the emergency room to improve predictions of resource use and length of stay for acute inpatient admissions in Ontario

Introduction The use of emergent status is believed to provide an easily auditable approach towards capturing patient acuity. Current case-mix methodologies in Ontario for the acute inpatient population make very limited use of the emergent status of patients (whether the patient was admitted from the emergency room). These patients tend to be longer stay, and current resource utilization indicators are poor predictors of patient-episode cost. The average patient who is admitted to an Ontario acute inpatient facility from an emergency room stays 3.5 days longer, costs $685 more and is 4 times more likely to die in hospital than a patient who is not admitted from an emergency room at that facility (unadjusted for case mix).