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Prolonged length of stay in the emergency department in high‐acuity patients at a C hinese tertiary hospital
Author(s) -
Ye Ligang,
Zhou Guangju,
He Xiaojun,
Shen Weifeng,
Gan Jianxin,
Zhang Mao
Publication year - 2012
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/j.1742-6723.2012.01588.x
Subject(s) - medicine , emergency department , emergency medicine , tertiary care , tertiary level , medical emergency , nursing , mathematics education , mathematics
Abstract Objective ED overcrowding is a worldwide issue, with most evidence coming from developed countries. Until now, little was known about this subject in C hina. The aim of this study was to investigate the situation of prolonged lengths of stay ( LOS ) in the ED for high‐acuity patients in a C hinese tertiary hospital and to identify associated factors. Methods A retrospective study was performed in a C hinese tertiary hospital from 1 J anuary to 31 D ecember 2010. The primary outcomes were ED LOS and associated factors in overall high‐acuity patients. Multivariate C ox regression analysis was used. Results In this consecutive study period, 7966 high‐acuity patients presenting to the ED were triaged to the resuscitation room. The median LOS in the ED for these patients was 10.6 h ( IQR , 3.1–23.1 h). In the multivariate analysis, the most significant factor associated with prolonged LOS was boarding for more than 2 h ( OR , 4.29; 95% CI , 4.03–4.57). Patients requiring emergency operation or intensive care unit admission experienced a shorter LOS ( OR , 0.56 and 0.76; 95% CI , 0.53–0.60 and 0.71–0.81, respectively). Older patients, night shift arrivals, non‐spring visitors, general internal medicine patients and patients leaving without receiving advanced therapy had longer LOS . Conclusions We found an excessive LOS in the resuscitation room in this tertiary hospital. The most significant reason for prolonged LOS was boarding block. Shortage of inpatient beds and reluctance of the wards to admit these patients might be the primary reasons for extremely long boarding.