BackgroundProlonged length of hospital stay is the most common indicator of poor quality of health care and inefficient utilization of hospital resources. Prolonged hospital stay associated with increased mortality, hospital-acquired infection, and unnecessary utilization of hospital bed and other resources. Predicting length of hospital stay facilitates resource designing and initiates quality improvement activities. However, data regarding the prolonged length of hospital stays, and associated factors were a scarce in Ethiopia.MethodsA hospital-based cross-sectional study was conducted on a sample of 316 adult patients from December 1 to January 10, 2022. A consecutive sampling technique was used during sampling procedure. A structured questionnaire was used to collect data regarding sociodemographic factors, clinical factors, medication factors, and behavioral factors through interview, medical record review and by using check list. The data was entered into the epidata4.6 version and exported to SPSS Version25 for binary logistic regression analysis. To identify factors associated with outcome variable, candidate variables (p<0.25) were fitted to multivariable analysis, and those with P-values<0.05 were considered as factors associated with prolonged length of hospital stay. Odds ratio with corresponding 95% CI was used to indicate the strength of association of variables with prolonged length of hospital stay.ResultOne fourth (24.7%) of the study participants experienced a prolonged length of stay at surgical ward. The odd of a prolonged length of hospital stay was high among patients who had comorbid condition [AOR=4.59, at 95% CI= (2.46-8.56)], who developed surgical site infection [AOR=5.02 at 95% CI= 1.97-12.80)], and who developed hospital acquired pneumonia during hospital stay [AOR= 3.43 at 95% CI= (1.36-8.64)].Conclusion and recommendationNear to quarter of the study participants’ experienced prolonged length of hospital stays. Comorbid condition, surgical site infection, and hospital acquired pneumonia were factors associated with prolonged length of hospital stay at surgical ward. Quality of care could be improved by adjusting surgical ward environment to prevent hospital acquired infection and focus on managing complication after surgery. Health care provider should be educating surgical patient about the risk of comorbidity on wound healing and early diagnosis and prevention of comorbid condition.
Background: In developing countries, the high mortality of breast cancer (BC) patients is strongly related to delayed presentation and subsequent advanced stage diagnosis, pointing to the need for improved detection programs. This study aims to assess the prevalence and factors associated with delayed presentation of BC patients at Hawassa University Oncology Center (HUOC), Hawassa, Ethiopia. Methods: A cross-sectional institution-based survey was conducted among BC patients between May 1st and August 30th, 2021. BC patients attending HUOC were included by consecutive sampling. Data was collected using an interviewer-administered questionnaire and medical record data extraction. A multivariable binary logistic regression model was carried out to identify associations between delayed presentation and potential risk factors. Results: A total of 150 BC patients participated in the study giving a response rate of 100%. Of these, 86 (57.3%) women presented with a long delay of ≥ 3 months. The median time to visit a health care provider after recognition of the first symptoms was 5.5 months. Urban residence (adjusted odds ratio (AOR) = 0.42; 95 %-CI=0.18-0.97) and not visiting of traditional healer (AOR=0.15, 95 %-CI=0.07-0.34) was associated with shorter delay time. No breast pain symptoms (AOR=8.57; 95 %-CI=3.47-21.15), no family history of BC (AOR=5.12; 95 %-CI=1.36-19.33), and travel distance ≥ 5 km (AOR=3.00, 95 %-CI=1.25-7.21) were associated with longer delay in presentation. Conclusion: A substantial proportion of patients with BC in southern Ethiopia have delays in seeking medical care. Interventional programs like public BC awareness campaigns are strongly needed to reduce delayed presentation and to increase early detection of cancer cases.
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