Determinants of Prolonged Length of Stay in Emergency Department Among Admitted Patients of a Tertiary Care Hospital of KPK, Pakistan
DOI:
https://doi.org/10.70749/ijbr.v3i6.3150Keywords:
Emergency Department, Length of Stay, Prolonged LOS, Crowding, Boarding, Tertiary Care Hospital, Pakistan, Emergency Medicine.Abstract
Background: Emergency department (ED) length of stay (LOS) is an important indicator of healthcare quality and emergency department efficiency. These all lead to long stays (LOS) which can cause poor patient outcomes, delayed patient management, increasing costs of healthcare and overcrowding. Emergency department congestion is further compounded because of scarce medical facilities, excess of patients, in developing countries, such as Pakistan. Objective: To calculate average Emergency Dept's (ED) length of stay (LOS) in admitted patients and to find the associated factors for length of stay (LOS) in the ED of Lady Reading Hospital. Methodology: The study was performed cross-sectional based in Emergency Department of Lady reading Hospital, Peshawar in 6-month duration from October 23rd, 2024 to April 23rd, 2025. The non-probability consecutive sampling technique was used to include a total of 385 admitted patients over 18 years. Have been excluded patients with trauma cases and pregnancy related cases. The data were collected by using a proforma of structured data to collect the information, which involved demographic information and factors that might be associated with extended LOS. SPSS 24 was used to analyze data. Results: The mean time spent in the emergency department was 8.7±3.6 hours. The most significant determinants were due to a failure of availability of inpatient beds (63.1%), ED crowding (60%), more than 4 hours spent on the ED floor (56.9%), delay to lab investigations (55.6%) and delay to specialist consultations (50.9%). Significant correlations with prolonged LOS included delays in investigations, delay in boarding, overcrowding, and delay in availability of bed space, with p<0.05 for each (p<0.05). Conclusion: Long Wait period at the EDs is a significant health care problem in the tertiary care hospitals of KP. The principal contributing factors were due to the lack of beds, overcrowding, delaying investigations, and long delay in boardings. A planned management strategy within the hospital and a better patient flow system must be in place to decrease the congestion in the ED and enhance the patient's clinical outcomes
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