# Predicting Hospital Admissions to Reduce Crowding in the Emergency Departments
## 1 Introduction
Reasons for the increase in this phenomenon are varied as illustrated in Table 1. It has been observed by experts that patients are increasingly demanding immediate health checks for non-urgent conditions. However, some experts also identify problems in the structure, which is not always able to solve problems quickly enough in the primary attention system, which is marked by long waiting times and is therefore being abandoned by users. One of the processes that has the greatest impact on emergency room congestion is the admission of patients from the ED into the hospital, as a result of the required logistics for patient management and bed allocation. The impact of an inefficient patient admission process in the ED is of high relevance. While only around 11% of the visits to the ED department end in an admission to the hospital, EDs are still the largest source of hospital admissions. Lengthy boarding times of patients that are waiting to be assigned a bed at the \begin{table}
\begin{tabular}{l l} \hline \hline
**Factors** & **Influence** \\ \hline Increased ED demand & Extremely busy service results in overcrowding \\  & due to overcapacity \\ \hline Increased hospital occupancy & Hinders bed allocation process \\ \hline Increasing patient acuity & An aging population requires more workup \\  & and treatment \\ \hline Patient self-referral & Patients who bypass the primary healthcare \\  & system overcrowd Eds \\ \hline Inappropriate triage & Several hospitals implement non-approved \\  & triage systems that result in decreased \\  & efficiency and longer waiting times \\ \hline \hline \end{tabular}
\end{table} 
Table 1: Factors affecting crowding in hospitals. hospital use precious resources such as time, space, and medical attention, which should instead be used in other ED tasks, and contribute to the overcrowding of the service [12]. Over the past few years, various solutions have been proposed to resolve this issue, the most significant of which is the simplification of the admission procedure [13], the addition of more doctors to the admission process of both hospitals and emergency department [3; 14; 15], an optimized process of early hospital discharges [16; 17], or the creation of an ED dependent unit for short-length stays [18]. However, none of them appears to be easily implementable without significant economic investment, or sustainable in a situation in which the number of visits to emergency departments will continue to rise. In contrast, monitorization of the admission process and anticipation of hospital admissions can potentially help optimize the use and allocation of resources in a sustainable way, thus improving the quality of emergency care and user satisfaction. Data collected in hospital databases and shared through Health Information Exchange (HIE) platforms can be used to make early predictions of inpatient admission and assist the implementation of actionable measures. In the current system, the process of inpatient admission to the hospital from the ED starts after the visit is completed. That means that after the visit, the patient must wait in ED facilities--crowding them unnecessarily--while the administrative staff processes their admission and allocates them a bed in the hospital. With an early prediction of admission, for example at the moment of arrival of the patient in the ED, the administrative staff would be able to carry out this process while the patient goes through the ED visit in a simultaneous rather than sequential way.