Predictors of patient length of stay in 9 emergency departments
Affiliations
- Department of Emergency Medicine, University of Colorado Denver School of Medicine, Aurora, CO 80045, USA
- Division of Emergency Medicine; Washington University in St Louis School of Medicine, St Louis, MO 63110, USA
Correspondence
- Corresponding author. Department of Emergency Medicine, University of Colorado Denver SOM, Aurora, CO 80045, USA. Tel.: +1 720 848 5569 (office), +1 716 390 1288 (cell).
Affiliations
- Department of Emergency Medicine, University of Colorado Denver School of Medicine, Aurora, CO 80045, USA
- Division of Emergency Medicine; Washington University in St Louis School of Medicine, St Louis, MO 63110, USA
Correspondence
- Corresponding author. Department of Emergency Medicine, University of Colorado Denver SOM, Aurora, CO 80045, USA. Tel.: +1 720 848 5569 (office), +1 716 390 1288 (cell).
Affiliations
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health and Science University, Portland, OR 97239, USA
Affiliations
- Department of Emergency Medicine, University of Colorado Denver School of Medicine, Aurora, CO 80045, USA
Affiliations
- Department of Biomedical Informatics and Emergency Medicine, Vanderbilt University, Nashville, TN 37232, USA
Affiliations
- Department of Emergency Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA
Affiliations
- Department of Emergency Medicine, University of Missouri-Kansas City, Truman Medical Center, Kansas City, MO 64139, USA
Affiliations
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
Affiliations
- Department of Emergency Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA
- Geriatric Research, Education and Clinical Center, James J. Peters VAMC, Bronx, NY 10468, USA
Affiliations
- Department of Emergency Medicine, University of Rochester, Rochester, NY 14642, USA
Affiliations
- Departments of Emergency Medicine, George Washington University School of Medicine and Department of Health Policy, George Washington School of Public Health, Washington, DC 20037, USA
Affiliations
- Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
Affiliations
- Department of Emergency Medicine, George Washington University, Washington, DC 20037, USA
Affiliations
- Department of Emergency Medicine and Public Health and Preventive Medicine, Oregon Health and Science University, Portland, OR 97239, USA
Article Info
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Abstract
Objectives
Prolonged emergency department (ED) length of stay (LOS) is linked to adverse outcomes, decreased patient satisfaction, and ED crowding. This multicenter study identified factors associated with increased LOS.
Methods
This retrospective study included 9 EDs from across the United States. Emergency department daily operational metrics were collected from calendar year 2009. A multivariable linear population average model was used with log-transformed LOS as the dependent variable to identify which ED operational variables are predictors of LOS for ED discharged, admitted, and overall ED patient categories.
Results
Annual ED census ranged from 43 000 to 101 000 patients. The number of ED treatment beds ranged from 27 to 95. Median overall LOS for all sites was 5.4 hours. Daily percentage of admitted patients was found to be a significant predictor of discharged and admitted patient LOS. Higher daily percentage of discharged and eloped patients, more hours on ambulance diversion, and weekday (vs weekend) of patient presentation were significantly associated with prolonged LOS for discharged and admitted patients (P < .05). For each percentage of increase in discharged patients, there was a 1% associated decrease in overall LOS, whereas each percentage of increase in eloped patients was associated with a 1.2% increase in LOS.
Conclusions
Length of stay was increased on days with higher percentage daily admissions, higher elopements, higher periods of ambulance diversion, and during weekdays, whereas LOS was decreased on days with higher numbers of discharges and weekends. This is the first study to demonstrate this association across a broad group of hospitals.
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