Abstract
BackgroundLength of stay is an important indicator of quality of care in Emergency Departments (ED). This study explores the duration of patients’ visits to the ED for which they are treated and released (T&R).MethodsRetrospective data analysis and multivariate regression analysis were conducted to investigate the duration of T&R ED visits. Duration for each visit was computed by taking the difference between admission and discharge times. The Healthcare Cost and Utilization Project (HCUP) State Emergency Department Databases (SEDD) for 2008 were used in the analysis.ResultsThe mean duration of T&R ED visit was 195.7 minutes. The average duration of ED visits increased from 8 a.m. until noon, then decreased until midnight at which we observed an approximately 70-minute spike in average duration. We found a substantial difference in mean duration of ED visits (over 90 minutes) between Mondays and other weekdays during the transition time from the evening of the day before to the early morning hours. Black / African American patients had a 21.4-minute longer mean duration of visits compared to white patients. The mean duration of visits at teaching hospitals was substantially longer than at non-teaching hospitals (243.8 versus 175.6 minutes). Hospitals with large bed size were associated with longer duration of visits (222.2 minutes) when compared to hospitals with small bed size (172.4 minutes) or those with medium bed size (166.5 minutes). The risk-adjusted results show that mean duration of visits on Mondays are longer by about 4 and 9 percents when compared to mean duration of visits on non-Monday workdays and weekends, respectively.ConclusionsThe duration of T&R ED visits varied significantly by admission hour, day of the week, patient volume, patient characteristics, hospital characteristics and area characteristics.
Highlights
Length of stay is an important indicator of quality of care in Emergency Departments (ED)
We explored the relationship between total volume of visits with both mean and median duration at EDs by admission hour.f As shown in Figure 1, the mean duration of ED visits increased from 8 a.m. until noon, decreased until midnight at which time we observed an approximately 70-minute spike in mean duration
Our results show that the mean duration for a treated and released (T&R) ED visit was slightly above 3 hours and it varied considerably by admission hour and day of the week, patient volume, patient characteristics, hospital characteristics and area characteristics
Summary
Length of stay is an important indicator of quality of care in Emergency Departments (ED). Length of stay (LOS) is perceived as an important indicator of quality of care in Emergency Departments (EDs) [1]. Researchers deconstructed the association between static crowding measures (waiting room volume, census, number boarding, and inpatient occupancy) and waiting room, treatment, and boarding times experienced by ED patients [4]. The literature finds that when more people are waiting to be treated, intervals between phases of care at EDs lengthen and the waiting line becomes longer. This illustrates the fundamental relationship between crowding (waiting lines) and delays in patient care [5]. Certain census variables (e.g., the number of admissions from the ED per day) and the number of intensive care and cardiac telemetry units affect ED length of stay across many hospital settings [9]
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