Factors Affecting the Length of Stay of Patients in Emergency Department Observation Units at Teaching and Research Hospitals in Turkey

Abstract

SUMMARYObjectivesThis study aimed to determine the reasons for long stays in monitoring units and to propose a solution.MethodsThe patients who were followed in monitoring units of emergency service and the factors affecting the length of their hospital stay were analyzed retrospectively. Demographic features, their initial complaint that lead to monitoring, diagnosis, their means of arrival to emergency service, their admittance date and hour, medical history, basic vital signs, length of stay in emergency service, invasive interventions, intubation, mortality rates, consultations, and clinical results were evaluated.ResultsThe study included 603 patients. Average emergency service stay in monitoring unit was found to be 6.5 hours. In addition, 15 patients (2.5%) stayed 24 hours or longer, and 78 patients (12.9%) stayed 12 to 24 hours. Of the 15 patients who stayed in emergency service for 24 hours or more, 8 (53.3%) stayed because there wasn't enough space in intensive care units. The most prevalent complaint for admission to the emergency service was chest pain (25.5%), followed by dyspnea (21.9%) and tachycardia (11.6%).ConclusionsFor real emergency conditions, monitoring units are necessary to follow patients closely and to perform immediate interventions. The fullness of the intensive care units primarily affects the emergency service and leads to long stays in emergency service as patients are waiting to be admitted to the intensive care unit. As the number of consultations increases, the monitoring period is prolonged.

Factors contributing to delay intensive care unit admission of critically ill patients from the adult emergency Department in Tikur Anbessa Specialized Hospital

“…This study reveals that lack of ICU bed (AOR = 0.022, 95% CI: (0.002,0.201)) has a significant association with delayed ICU admission and it shows that critically ill patients were less likely to transfer with less than 6 h by 97% when there is lack of ICU bed. This study was consistent with a study conducted in Turkey which shows, lack of space in the intensive care unit had a significant association for delayed ICU admission [ 12 ]. Furthermore, this study was supported with another study conducted in Ethiopia, which shows shortage of ICU beds were significant association with delayed ICU admission(AOR = 8.7, 95%CI:(3.2–23.2)) [ 16 ].…”

Determining emergency physicians' and nurses' views concerning older patients: a mixed-method study

“…In another study, patients aged 75 years or older constituted the largest proportion of the total study population (29.5%, n = 178), and 52.4% (n = 316) of the monitored patients were aged at least 65 years (Mahsanlar et al, 2014). The results of these studies indicated that geriatric patients constituted a major proportion of the patients who required monitored observation.…”

An integrated statistical model of Emergency Department length of stay informed by Resilient Health Care principles

“…Studies of ED length of stay have identified both extrinsic and intrinsic factors. Two broad extrinsic factors, which are not under the control of the ED, have been identified (Jarvis, 2016): increased attendance/ departmental occupancy (Bergs et al, 2014) and bed availability or capacity in wards to which patients may be discharged (Mahsanlar et al, 2014). Intrinsic factors include patient characteristics, for example older patients (Hosseininejad et al, 2017), Ross, A. J., Murrells, T., Kirby, T., Jaye, P., & Anderson, J. E. (2019).…”