| Predictive Factors of Emergency Department Length of Stay: Analyzing National Emergency Department Data |
Minha Kim1,2
, Sujeong Lee3, Minyoung Choi1, Doyeop Kim1,4
, Junsang Yoo3
, Tae Gun Shin1
, Jin-Hee Lee5
, Seongjung Kim5,6
, Hansol Chang1,3
, Eunsil Ko5
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1Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, 06351
2Department of Medical Sciences, Graduate school of Kangwon National University, Chuncheon, Republic of Korea, 24341
3Department of Health Sciences and Technology, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea, 06351
4Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea
5National Emergency Medical Center, National Medical Center, Seoul, Korea
6Department of Emergency Medicine, Chosun University Hospital, Gwangju, Korea |
| Correspondence
Hansol Chang Email: briquet90@naver.com, Eunsil Ko Email: eunsil0802@nmc.or.kr |
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Received: September 4, 2024. Revised: September 26, 2024. Accepted: October 8, 2024. Published online: October 16, 2024. |
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| ABSTRACT |
Objective
This study aimed to identify and analyze the factors influencing Emergency Department Length of Stay (ED LOS) using a nationwide database to improve emergency care efficiency.
Methods
This retrospective study utilized data from the National Emergency Department Information System (NEDIS) in South Korea, covering 25,578,263 ED visits from 2018 to 2022. Patient demographics, clinical characteristics, and ED operational variables were examined. The study employed univariate and multivariate logistic regression analyses to assess the association between these factors and prolonged ED LOS, defined as six hours or more.
Results
Among the 25,578,263 patients included, median ED LOS was 2.1 hours (interquartile range [IQR], 1.050 – 3.830 hours), with 12.6% experienced a prolonged ED LOS. Elderly patients (aged ≥ 65 years) were significantly more likely to experience prolonged ED LOS (adjusted odds ratio [aOR]: 1.415, 95% confidence interval [CI]: 1.411–1.419). Patients transferred from other hospitals (aOR: 1.469, 95% CI: 1.463–1.474) and those arriving by 119 ambulances (aOR: 1.093, 95% CI: 1.077–1.108) also had higher odds of prolonged LOS. Conversely, pediatric patients had a lower likelihood of extended stays (aOR: 0.682, 95% CI: 0.678–0.686). Severe illness, including sepsis (aOR: 1.324, 95% CI: 1.311–1.340) and COVID-19 infection (aOR: 1.413, 95% CI: 1.399–1.427), were strongly associated with prolonged LOS.
Conclusion
Prolonged ED LOS is influenced by a combination of patient demographics, clinical severity, and systemic factors. Targeted interventions focusing on older adults, severe illness, and operational inefficiencies, such as hospital transfers, are essential for reducing ED LOS and improving overall emergency care delivery. |
| Keywords:
emergency department, emergency medicine, length of stay, NEDIS |
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