Factors Affecting Length of Stay in the Pediatric Emergency Department

Li, Sung-Tse; Chiu, Nan-Chang; Kung, Wen‐Chuan; Chen, Juei-Chao

doi:10.1016/j.pedneo.2012.11.014

Cited by 11 publications

(10 citation statements)

References 34 publications

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“…The risk factors that we studied may be different from what was considered by previous studies from other regions because of differences in organisation of health systems. For example, Wiler et al32 in USA, studied the impact of ambulance diversion on hospital stay which was not considered by us while in a paediatric ED, Li et al33 found that delayed hospitalization greater than 16 hours had the longest LOS.…”

Section: Discussionmentioning

confidence: 96%

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Patterns of paediatric emergency admissions and predictors of prolonged hospital stay at the children emergency room, University of Calabar Teaching Hospital, Calabar, Nigeria

Enyuma¹,

Anah²,

Pousson³

et al. 2019

Afr H. Sci.

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BackgroundThere is a high prevalence of paediatric emergency cases in less developed countries. However, prolonged hospital stay at emergency units may further overstretch the facilities.ObjectiveTo assess the patterns of presentations, services offered and predictors of a prolonged stay at the Children Emergency Room of a tertiary hospital in Southern Nigeria.MethodsThis prospective cross-sectional, study was conducted at the University of Calabar Teaching Hospital, Nigeria from 1st January–31st December 2014. Socio-demographic and clinical characteristics of consecutively recruited children (n=633) were recorded in a proforma. Binary logistic regression was conducted to determine predictors of prolonged stay (>72 hours)ResultThe median age of participants was 2 (1 – 4.6) years. Three-fifths of children were admitted at off-hours and the commonest symptom was fever (73.9%). About 16.4% (95%CI:13.6% – 19.4%, n= 103/633) of the children had prolonged stay while those with sepsis had the longest mean stay (65.5±72.1 hours). Children admitted on account of Sickle cell disease (OR:11.2, 95%CI:1.3–95.1, P-value = 0.03), Malaria (OR:10.7, 95%CI:1.4–82.5, P-value = 0.02) or sepsis (OR:10.5, 95%CI:1.3 – 82.7, P-value = 0.03) had higher odds of prolonged hospital stay. There was no significant difference in hospital stay among children admitted by the consultant as compared to other health personnel (P-value = 0.08).ConclusionPrevention and proper management of Sickle cell disease and malaria reduces paediatric hospital stay in our environment. Paediatric emergency medicine should be re-organized to cater for high volume of off-hour admissions.

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Section: Discussionmentioning

confidence: 96%

“…Although pattern of presentations and predictors of paediatric hospital stay has been reported in the high income countries30–33, little is known currently in our environment.…”

Section: Introductionmentioning

confidence: 99%

Patterns of paediatric emergency admissions and predictors of prolonged hospital stay at the children emergency room, University of Calabar Teaching Hospital, Calabar, Nigeria

Enyuma¹,

Anah²,

Pousson³

et al. 2019

Afr H. Sci.

View full text Add to dashboard Cite

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“…Some of the covariates, such as consultations, laboratory tests, CT exams, and radiographs have previously been mentioned [14, 15, 25, 26]. Despite the fact that more exams indicate longer ED LOS, the magnitude of the impact of these exams and services has rarely been quantified and compared.…”

Section: Discussionmentioning

confidence: 99%

Predicting Length of Stay among Patients Discharged from the Emergency Department—Using an Accelerated Failure Time Model

et al. 2017

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BackgroundEmergency department (ED) crowding continues to be an important health care issue in modern countries. Among the many crucial quality indicators for monitoring the throughput process, a patient’s length of stay (LOS) is considered the most important one since it is both the cause and the result of ED crowding. The aim of this study is to identify and quantify the influence of different patient-related or diagnostic activities-related factors on the ED LOS of discharged patients.MethodsThis is a retrospective electronic data analysis. All patients who were discharged from the ED of a tertiary teaching hospital in 2013 were included. A multivariate accelerated failure time model was used to analyze the influence of the collected covariates on patient LOS.ResultsA total of 106,206 patients were included for analysis with an overall medium ED LOS of 1.46 (interquartile range = 2.03) hours. Among them, 96% were discharged by a physician, 3.5% discharged against medical advice, 0.5% left without notice, and only 0.02% left without being seen by a physician. In the multivariate analysis, increased age (>80 vs <20, time ratio (TR) = 1.408, p<0.0001), higher acuity level (triage level I vs. level V, TR = 1.343, p<0.0001), transferred patients (TR = 1.350, p<0.0001), X-rays obtained (TR = 1.181, p<0.0001), CT scans obtained (TR = 1.515, p<0.0001), laboratory tests (TR = 2.654, p<0.0001), consultation provided (TR = 1.631, p<0.0001), observation provided (TR = 8.435, p<0.0001), critical condition declared (TR = 1.205, p<0.0001), day-shift arrival (TR = 1.223, p<0.0001), and an increased ED daily census (TR = 1.057, p<0.0001) lengthened the ED LOS with various effect sizes. On the other hand, male sex (TR = 0.982, p = 0.002), weekend arrival (TR = 0.928, p<0.0001), and adult non-trauma patients (compared with pediatric non-trauma, TR = 0.687, p<0.0001) were associated with shortened ED LOS. A prediction diagram was made accordingly and compared with the actual LOS.ConclusionsThe influential factors on the ED LOS in discharged patients were identified and quantified in the current study. The model’s predicted ED LOS may provide useful information for physicians or patients to better anticipate an individual’s LOS and to help the administrative level plan its staffing policy.

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“…Globally, patients' length of stay in the ED has been a concern due to its impact on patient safety and satisfaction (4). Each patient's LOS is measured from the patient's initial arrival to the transfer to the other department, and it is used as a key to assessing the efficiency of improving management and clinical performance (5).…”

Section: Introductionmentioning

confidence: 99%

Factors Contributing to Length of Stay Prolongation among Emergency Room Patients during the Covid-19 Pandemic: A Study at Persada Hospital

Simanungkalit

Holipah

Dewanto

et al. 2022

JKB

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Extended length of stay (LOS) in the Emergency Department (ED) results in crowding, potentially causing adverse events and patient dissatisfaction. The Covid-19 pandemic has forced hospitals to implement screening procedures that can extend the LOS of patients in the ED. This study aimed to provide an overview of changes in ED LOS during the pandemic and its contributing factors. This study used a descriptive approach through observation and interviews. LOS observations were conducted using the time & motion study method to determine the average time in each ED stage. The observation results identified the differences in the average LOS during the Covid-19 pandemic, which was 2 hours 39 minutes 52 seconds, and the longest time was on laboratory examination (2 hours 59 minutes 27 seconds). A lengthy laboratory examination duration is due to the additional laboratory examination procedure (serology) for SARS COV-2, suboptimal screening team, and the absence of notification in the hospital information system.

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Factors Affecting Length of Stay in the Pediatric Emergency Department

Cited by 11 publications

References 34 publications

Patterns of paediatric emergency admissions and predictors of prolonged hospital stay at the children emergency room, University of Calabar Teaching Hospital, Calabar, Nigeria

Patterns of paediatric emergency admissions and predictors of prolonged hospital stay at the children emergency room, University of Calabar Teaching Hospital, Calabar, Nigeria

Predicting Length of Stay among Patients Discharged from the Emergency Department—Using an Accelerated Failure Time Model

Factors Contributing to Length of Stay Prolongation among Emergency Room Patients during the Covid-19 Pandemic: A Study at Persada Hospital

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