Factor associated with length of stay more than 4 hours at the Emergency Department of Thammasat University Hospital

Abstract

Introduction: Emergency department crowding is a common problem in tertiary care hospital. Crowding reduces all aspect of quality of emergency care resulting in prolonged patient waiting times, delay in patient treatment. At present, there have been some patients with length of stay more than 4 hours at the emergency room. The purpose of the study was to know the characteristics of patients with duration of treatment in the emergency room for more than 4 hours of Thammasat University Hospital. And factors that were correlated with the patients admitted to the hospital in patients with duration of treatment in the emergency room for more than 4 hours of Thammasat University Hospital.

Method: The study design was descriptive retrospective observational study in patient length of stay more than 4 hours at the Emergency Department of Thammasat University Hospital in July 2013. Categorical data were calculated and reported by percentage. Continuous data were reported by mean ± S.D. Chi-squared and Independent sample t-test was used for statistical analysis.

Result: There were a total of 352 (12.8%) patients with length of stay more than 4 hours at the Emergency Department of Thammasat University Hospital. 59.1% of patient were male. 71 - 80 years age group was the most largest group followed by 61 - 70, 41 - 50 years age group. which were 20%, 15.1% and 12.6% respectively. Mean age was 51.44 ± 24.35. Emergency triage level group was the most largest group followed by urgency and traumatic group as 40%, 37.2% and 19.6% respectively. The most common diagnosis was acute gastroenteritis. Patient with length of stay 4 - 8 hours, 8 - 24 hours, more than 24 hours was 63.4%, 27% and 9.7% respectively. Mean length of stay was 11.5 ± 16.49 hours.

Discussion and Conclusion: The most largest group of patients with length of stay more than 4 hours was elderly patient, emergency triage level, 4 - 8 hours. Most common disease in this study was acute gastroenteritis. The most common diagnosis in 4 - 8 hours, 8 - 24 hours, more than 24 hours patient were head injury, pneumonia and congestive heart failure respectively. Factor associated with admission were using investigation, type of radiologic investigation, emergency department diagnosis and consultation. Most patient in this study had to consult the specialist and needed admission. Medicine department was the most consulted specialty. Improving availability of inpatient beds may reduce emergency department crowding.

Key words: Length of stay, Emergency department