A national survey of observation units in the United States

Am J Emerg Med. 2003 Nov;21(7):529-33. doi: 10.1016/j.ajem.2003.08.012.


The objective of this study was to survey the use of observation units (OUs) in the United States. A written survey was mailed to every third hospital (sequential by zip code) in the United States. There was a 32.9% response to the survey (522 of 1588 hospitals). A total of 18.8% of hospitals had an OU with another 11.6% planning to open an OU. Those hospitals that had OUs had a higher overall ED census, higher rate of diversion of ambulances, and were more likely to be in metropolitan areas (P <.05), but there was no relationship to payor mix or to ED hospital admission rate. The OUs were characterized by a mean 4.8 years in existence, 57.3% ED administratively responsible, 59.4% ED clinically responsible, a mean of 1330 patients per year, an average length of stay of 15.3 hours, a 4.2 nurse-to-patient ratio, and 22.3% hospital admission rate.

MeSH terms

  • Emergency Service, Hospital / statistics & numerical data*
  • Hospital Units / statistics & numerical data*
  • Humans
  • Observation*
  • Patient Admission / statistics & numerical data*
  • United States