Factors associated with emergency department length of stay of internal medicine patients

Abstract

Emergency Department (ED) Length Of Stay (ED-LOS) is associated with quality of care, patient safety and treatment outcome. The aim of this study is to identify factors associated with ED-LOS of internal medicine patients and provide recommendations to shorten ED-LOS. A retrospective cohort study was conducted in a single center in the Netherlands. Anonymised data of 7,380 ED attendances from January 2016 to January 2018 were analyzed. Data included time of ED arrival and departure, sex, age, source of referral, triage category, first or consecutive visit and number of radiological examinations. Univariate analyses were used. Mean ED-LOS was 220 minutes. Factors which significantly prolonged ED-LOS were older age, source of referral, triage category, need for admission, first visit, number of radiological examinations, presentation in winter or spring and time of arrival (day and evening). Several patient and circumstantial factors are associated with ED-LOS. To shorten ED-LOS, we recommend to anticipate need for admission for older patients who arrive by ambulance and to create time slots in the radiology program and to restructure the morning report.

Length of stay and its associated factors among adult patients who visit Emergency Department of University Hospital, Eastern Ethiopia

“…In the current study, 42.25% (95% CI: 37.5%−47.0%) of patients stay longer than 24 h in the ED. According to the Ethiopian Hospital Service Transformation Guidelines, 13 the LOS in the ED should not be prolonged for more than 24 h, The current finding shows the proportion of patients who stayed longer than the recommended hours is higher than the result of the study conducted in the Netherlands, 14 Switzerland, France, and the United States. The variation could be attributed to differences in sample size and quality of healthcare services.…”

“…Similarly, the previously conducted studies identified the association of the triage type with the LOS in ED but with different description and number of triage categories. 14,19,20 Moreover, the diagnostic investigation was significantly associated with the LOS. Patients without laboratory and radiological evaluations spend less time in an ED compared to their counterparts.…”

“…The variation could be attributed to differences in sample size and quality of healthcare services. 3,[14][15][16][17][18] Patients treated at orange triage type were less likely to stay in ED compared to patients treated at the green triage type. Similarly, the previously conducted studies identified the association of the triage type with the LOS in ED but with different description and number of triage categories.…”

“…The variation could be attributed to differences in sample size and quality of healthcare services. 3,14 –18…”

“…In addition, the interviewer-administered questionnaire was used to address the variables including sociodemographic characteristics, organizational factors, diagnostic investigations, and clinical characteristics of patients that were developed through an extensive review of relevant literatures. 11,14,18…”