Length of stay at adult Emergency Department and associated factors in West Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia, 2022

Abstract

Abstract Introduction: Emergency Department Length of Stay is the length of time for emergency cases from arrival to the Emergency Department to the time when the patient leaves the department which should not exceed 24 hours. Prolonged length of stay interferes with the main goal of emergency care and results in adverse patient outcomes like nosocomial infection, dissatisfaction, morbidity, and mortality. Despite this, little is known about the length of stay and the factors that influence it in Ethiopia's Emergency Department. Objective: This study aimed to assess the length of stay at adult Emergency Department and associated factors in West Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia, 2022. Methods: An institution-based cross-sectional study was conducted on 495 patients admitted at West Amhara Comprehensive Specialized Hospitals Emergency Department from May 14 to June 15/2022. A systematic random sampling was employed to select study participants. A pretested structured interview-based questionnaire was used to collect data by using Kobo toolbox software. SPSS version 25 was used for data analysis. Bi-variable logistic regression analysis was carried out to select variables with P-value <0.25. The significance of association was interpreted using an Adjusted Odds Ratio (AOR) with a 95% confidence interval. Variables with P-value <0.05 in the multivariable logistic regression analysis were deduced to be significantly associated with length of stay. Result: Out of 512 enrolled participants, 495 was participated with a response rate of 96.7%. The prevalence of prolonged length of stay in adult Emergency Department was 46.5% (95%CI: 42.1, 51.1). Lack of insurance (AOR: 2.11; 95% CI: 1.22, 3.65), presenting without communication (AOR: 1.98; 95% CI: 1.07, 3.68), delayed consultation (AOR: 9.5; 95% CI: 5.00, 18.03), overcrowding (AOR: 4.98; 95% CI: 2.13, 11.68), and shift change experience (AOR: 3.67; 95% CI: 1.30, 10.37) were significantly associated with prolonged length of stay. Conclusion: The result of this study is found to be high based on Ethiopian target Emergency Department patient length of stay. Lack of insurance, presentation without communication, delayed consultation, overcrowding, and shift change experience were significant factors for prolonged Emergency Department length of stay. Therefore, interventions like expansion of organizational setup are needed to decrease the length of stay to the acceptable level. Key words: Emergency Department; Length of Stay; Northwest Ethiopia