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      Prolonged length of stay and its associated factors at adult emergency department in amhara region comprehensive specialized hospitals, northwest Ethiopia

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          Abstract

          Background

          Prolonged length of stay at the emergency department 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.

          Methods

          An institution-based cross-sectional study was conducted on 495 patients admitted at Amhara region 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 with a 95% confidence interval. Variables with P-value < 0.05 in the multivariable logistic regression analysis were inferred to be significantly associated with length of stay.

          Result

          Out of 512 enrolled participants, 495 were participated with a response rate of 96.7%. The prevalence of prolonged length of stay in the adult emergency department was 46.5% (95%CI: 42.1, 51.1). Lack of insurance (AOR: 2.11; 95% CI: 1.22, 3.65), non-communicative presentation (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 an acceptable level.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12873-023-00804-y.

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          Emergency care in 59 low- and middle-income countries: a systematic review

          Ziad Obermeyer, Samer Abujaber, Maggie Makar … (2015)
          Abstract Objective To conduct a systematic review of emergency care in low- and middle-income countries (LMICs). Methods We searched PubMed, CINAHL and World Health Organization (WHO) databases for reports describing facility-based emergency care and obtained unpublished data from a network of clinicians and researchers. We screened articles for inclusion based on their titles and abstracts in English or French. We extracted data on patient outcomes and demographics as well as facility and provider characteristics. Analyses were restricted to reports published from 1990 onwards. Findings We identified 195 reports concerning 192 facilities in 59 countries. Most were academically-affiliated hospitals in urban areas. The median mortality within emergency departments was 1.8% (interquartile range, IQR: 0.2–5.1%). Mortality was relatively high in paediatric facilities (median: 4.8%; IQR: 2.3–8.4%) and in sub-Saharan Africa (median: 3.4%; IQR: 0.5–6.3%). The median number of patients was 30 000 per year (IQR: 10 296–60 000), most of whom were young (median age: 35 years; IQR: 6.9–41.0) and male (median: 55.7%; IQR: 50.0–59.2%). Most facilities were staffed either by physicians-in-training or by physicians whose level of training was unspecified. Very few of these providers had specialist training in emergency care. Conclusion Available data on emergency care in LMICs indicate high patient loads and mortality, particularly in sub-Saharan Africa, where a substantial proportion of all deaths may occur in emergency departments. The combination of high volume and the urgency of treatment make emergency care an important area of focus for interventions aimed at reducing mortality in these settings.
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            Interventions to reduce emergency department utilisation: A review of reviews

            Koen Van den Heede, Carine Van de Voorde (2016)
            Article 0 comments Cited 75 times – based on 0 reviews     Review now
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              The global need for essential emergency and critical care

              Carl Schell, Martin Gerdin Wärnberg, Anna Hvarfner … (2018)
              Critical illness results in millions of deaths each year. Care for those with critical illness is often neglected due to a lack of prioritisation, co-ordination, and coverage of timely identification and basic life-saving treatments. To improve care, we propose a new focus on essential emergency and critical care (EECC)—care that all critically ill patients should receive in all hospitals in the world. Essential emergency and critical care should be part of universal health coverage, is appropriate for all countries in the world, and is intended for patients irrespective of age, gender, underlying diagnosis, medical specialty, or location in the hospital. Essential emergency and critical care is pragmatic and low-cost and has the potential to improve care and substantially reduce preventable mortality.
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                Author and article information

                Contributors
                Asnake Gashaw Belayneh: asnakegashaw27@gmail.com
                Yemataw Zewdu Temachu: yematawzewdu@gmail.com
                Mengistu Abebe Messelu: abebemengistu7@gmail.com
                Mignote Hailu Gebrie: elatman.hailu86@gmail.com
                Journal
                Journal ID (nlm-ta): BMC Emerg Med
                Journal ID (iso-abbrev): BMC Emerg Med
                Title: BMC Emergency Medicine
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-227X
                Publication date (Electronic): 29 March 2023
                Publication date PMC-release: 29 March 2023
                Publication date Collection: 2023
                Volume: 23
                Electronic Location Identifier: 34
                Affiliations
                [1 ]GRID grid.442845.b, ISNI 0000 0004 0439 5951, Department of Emergency and Critical Care Nursing, College of Medicine and Health Sciences, , Bahir Dar University, ; Bahir Da, Ethiopia
                [2 ]GRID grid.59547.3a, ISNI 0000 0000 8539 4635, Department of Emergency and Critical Care Nursing, College of Medicine and Health Sciences, , University of Gondar, ; Gondar, Ethiopia
                [3 ]GRID grid.449044.9, ISNI 0000 0004 0480 6730, Department of Nursing, College of Medicine and Health Sciences, , Debre Markos University, ; Debre Markos, Ethiopia
                [4 ]GRID grid.59547.3a, ISNI 0000 0000 8539 4635, School of Nursing, College of Medicine and Health Sciences, , University of Gondar, ; Gondar, Ethiopia
                Article
                Publisher ID: 804
                DOI: 10.1186/s12873-023-00804-y
                PMC ID: 10053138
                PubMed ID: 36977998
                SO-VID: a328a824-362b-4a1c-8871-937391a3ef75
                Copyright © © The Author(s) 2023
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 7 November 2022
                Date accepted : 13 March 2023
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2023

                ScienceOpen disciplines: Emergency medicine & Trauma
                Keywords: emergency department,length of stay,northwest ethiopia
                Data availability:
                ScienceOpen disciplines: Emergency medicine & Trauma
                Keywords: emergency department, length of stay, northwest ethiopia

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