EVALUATION OF FACTORS THAT INFLUENCE PROLONGED EMERGENCY DEPARTMENT STAY AMONG ADMITTED PATIENTS IN UNIVERSITI KEBANGSAAN MALAYSIA MEDICAL CENTRE

Abstract

Background and aims: Emergency department (ED) stay is define as the period seen by ED doctors to the time of ward admission. In this study, prolonged ED stay is the length of stay (LOS) for more than 6 hours. This study was carried out to assess the factors influencing prolonged ED stay among admitted patients in Universiti Kebangsaan Malaysia Medical Centre (UKMMC).

Materials and methods: Data was collected retrospectively from medical records. A total of 662 cases of admission to the ward through ED was taken from 1^st January 2016 to 30^th June 2016 in UKMMC. Patients with incomplete data and those admitted through outpatient clinic and Patient Admission Centre (PAC) were excluded.

Results: The median length of stay in ED was 6 hours. There were 280 (42.3%) patients with prolonged ED LOS. Medical department had the maximum median and paediatrics department had the minimum median ED LOS which were 8 hours and 3 hours respectively. The median referral time for patient with prolonged ED stay was 2 hours and 39 minutes, whereas for patient with ED stay of less than 6 hour was 1 hour and 35 minutes. A total of 31 patients (4.68%) out of 662 patients required ICU admissions. Among these, 21(67.74%) patients had prolonged ED stay. The average BOR per month and average rate of admission per day ranging from 61.22% to 65.24% and from 33.2% to 40.3% respectively, which remains plateau throughout the study period.

Conclusion: Two independent factors were found to be the major reasons for prolonged ED length of stay namely the type of specialty involved and lack of inpatient bed. The result of this study serves as the basis for further research to minimise ED LOS.