Background: Academic and non-academic emergency departments (EDs) are regularly compared in clinical\noperations benchmarking despite suggestion that the two groups may differ in their clinical operations\ncharacteristics. and outcomes. We sought to describe and compare clinical operations characteristics of academic\nversus non-academic EDs.\nMethods: We performed a descriptive, comparative analysis of academic and non-academic adult and general EDs\nwith 40,000+ annual encounters, using the Academy of Academic Administrators of Emergency Medicine (AAAEM)/\nAssociation of Academic Chairs of Emergency Medicine (AACEM) and Emergency Department Benchmarking\nAlliance (EDBA) survey results. We defined academic EDs as primary teaching sites for emergency medicine (EM)\nresidencies and non-academic EDs as sites with minimal resident involvement. We constructed the academic and\nnon-academic cohorts from the AAAEM/AACEM and EDBA surveys, respectively, and analyzed metrics common to\nboth surveys.\nResults: Eighty and 454 EDs met inclusion criteria for academic and non-academic EDs, respectively. Academic EDs\nhad more median annual patient encounters (73,001 vs 54,393), lower median proportion of pediatric patients (6.3%\nvs 14.5%), higher median proportion of EMS patients (27% vs 19%), and were more commonly designated as Level I\nor II Trauma Centers (94% vs 24%). Median patient arrival-to-provider times did not differ (26 vs 25 min). Median\nlength-of-stay was longer (277 vs 190 min) for academic EDs, and left-before-treatment-complete was higher (5.7%\nvs 2.9%). MRI utilization was higher for academic EDs (2.2% patients with at least one MRI vs 1.0 MRIs performed\nper 100 patients). Patients-per-hour of provider coverage was lower for academic EDs with and without\nconsideration for advanced practice providers and residents.\nConclusions: Demographic and operational performance measures differ between academic and non-academic\nEDs, suggesting that the two groups may be inappropriate operational performance comparators. Causes for the\ndifferences remain unclear but the differences appear not to be attributed solely to the academic mission.
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