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Efficiency measures of emergency departments: an Italian systematic literature review

  • Di Laura, Danilo1
  • D'Angiolella, Lucia1
  • Mantovani, Lorenzo1
  • Squassabia, Ginevra1
  • Clemente, Francesco1
  • Santalucia, Ida2
  • Improta, Giovanni2, 3
  • Triassi, Maria2, 3
  • 1 Università degli Studi di Milano-Bicocca, Monza, Lombardia, Italy , Monza (Italy)
  • 2 Universita degli Studi di Napoli Federico II, Napoli, Italy , Napoli (Italy)
  • 3 Università degli studi di Napoli Federico II, Napoli, Italy , Napoli (Italy)
Published Article
BMJ Open Quality
BMJ Publishing Group
Publication Date
Sep 07, 2021
DOI: 10.1136/bmjoq-2020-001058
PMID: 34493488
PMCID: PMC8424857
PubMed Central
  • 1506


Life expectancy globally increased in the last decades: the number of people aged 65 or older is consequently projected to grow, and healthcare demand will increase as well. In the recent years, the number of patients visiting the hospital emergency departments (EDs) rocked in almost all countries of the world. These departments are crucial in all healthcare systems and play a critical role in providing an efficient assistance to all patients. A systematic literature review covering PubMed, Scopus and the Cochrane Library was performed from 2009 to 2019. Of the 718 references found in the literature research, more than 25 studies were included in the current review. Different predictors were associated with the quality of EDs care, which may help to define and implement preventive strategies in the near future. There is no harmonisation in efficiency measurements reflecting the performance in the ED setting. The identification of consistent measures of efficiency is crucial to build an evidence base for future initiatives. The aim of this study is to review the literature on the problems encountered in the efficiency of EDs around the world in order to identify an organisational model or guidelines that can be implemented in EDs to fill inefficiencies and ensure access optimal treatment both in terms of resources and timing. This review will support policy makers to improve the quality of health facilities, and, consequently of the entire healthcare systems.

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