Prolonged length of stay and its associated factors at adult emergency department in amhara region comprehensive specialized hospitals, northwest Ethiopia

Abstract

Background Prolonged length of stay at the emergency department interferes with the main goal of emergency care and results in adverse patient outcomes like nosocomial infection, dissatisfaction, morbidity, and mortality. Despite this, little is known about the length of stay and the factors that influence it in Ethiopia’s emergency department. Methods An institution-based cross-sectional study was conducted on 495 patients admitted at Amhara region comprehensive specialized hospitals emergency department from May 14 to June 15/2022. A systematic random sampling was employed to select study participants. A pretested structured interview-based questionnaire was used to collect data by using Kobo toolbox software. SPSS version 25 was used for data analysis. Bi-variable logistic regression analysis was carried out to select variables with P-value < 0.25. The significance of association was interpreted using an Adjusted Odds Ratio with a 95% confidence interval. Variables with P-value < 0.05 in the multivariable logistic regression analysis were inferred to be significantly associated with length of stay. Result Out of 512 enrolled participants, 495 were participated with a response rate of 96.7%. The prevalence of prolonged length of stay in the adult emergency department was 46.5% (95%CI: 42.1, 51.1). Lack of insurance (AOR: 2.11; 95% CI: 1.22, 3.65), non-communicative presentation (AOR: 1.98; 95% CI: 1.07, 3.68), delayed consultation (AOR: 9.5; 95% CI: 5.00, 18.03), overcrowding (AOR: 4.98; 95% CI: 2.13, 11.68), and shift change experience (AOR: 3.67; 95% CI: 1.30, 10.37) were significantly associated with prolonged length of stay. Conclusion The result of this study is found to be high based on Ethiopian target emergency department patient length of stay. Lack of insurance, presentation without communication, delayed consultation, overcrowding, and shift change experience were significant factors for prolonged emergency department length of stay. Therefore, interventions like expansion of organizational setup are needed to decrease the length of stay to an acceptable level.

Perceived Causes and Effects of Overcrowding Among Nurses in the Emergency Departments of Tertiary Hospitals: A Multicenter Study

“…34 Prolonged length of stay was found to delay the goal of emergency care, resulting in poor quality of care and adverse patient outcomes. 35 Moreover, during a period of ED overcrowding, the highest percentage of deaths (38%) occurred among patients aged between 30-44 years, while 36% deaths occurred among patients aged between 60-74 years. 29 Previous studies have reported that an increase in patient waiting time due to overcrowding is the primary cause of the increase in the number of patients who leave the ED without being examined by a physician despite needing immediate medical care.…”

“… 34 Prolonged length of stay was found to delay the goal of emergency care, resulting in poor quality of care and adverse patient outcomes. 35 Moreover, during a period of ED overcrowding, the highest percentage of deaths (38%) occurred among patients aged between 30–44 years, while 36% deaths occurred among patients aged between 60–74 years. 29 …”

Performances and determinants of proficiency testing in clinical laboratory services at comprehensive specialized hospitals, northwest Ethiopia

“…A retrospective cross-sectional study was conducted at comprehensive specialized hospital laboratories in northwest Ethiopia from 2020 to 2022. There are three regional and two federal comprehensive specialized hospitals in the area 12 , 13 . The study was conducted in one federal (University of Gondar) and two regional (Debre Markos and Felege Hiwot) comprehensive specialized hospitals.…”