The Causes of Long-Term Hospitalization of Patients in the Emergency Ward of Rouhani and Beheshti Hospital

Introduction: The length of stay in the emergency department (ED) starts from entering the unit and does not end until the patient is discharged home, admitted to the hospital or until transferred to another department or other treatment center. This period of time indicates the optimal management of beds in the ED. It is used as a performance index to evaluate the quality of care in the ED and the evidence shows that a stay in the ED of more than ۶ hours is associated with an increase in mortality and morbidity. Therefore, the present study aims to investigate the causes of long-term stay (more than ۱۲ hours) patients in the ED of Ayatollah Rouhani Babol educational and treatment center is designed.Research method: This research was cross-sectional-retrospective. The study population consisted of all patients who referred to the ED of Rohani Babol Hospital in ۲۰۲۲. Sampling was done in the form of the entire census of the studied community. Data was collected using a checklist from Rouhani Hospital in Babol city. The collection tool was a pre-made checklist that included basic and demographic information of the patients. If a file did not have the desired information, or was incomplete, it was excluded from the study.Results: This study was conducted on ۴۰۰ patients who referred to the ED of Ayatollah Rouhani and Shahid Beheshti hospitals, who stayed in the emergency ward for more than ۱۲ hours. In this study, the average duration of hospitalization until the assignment of the patient by the emergency medicine specialist was ۵۷.۸±۸۲.۶ minutes. The average time from entering to leaving the ED was ۳۱.۸ ± ۲۱.۸ hours for men and ۳۳.۸ ± ۲۴.۴ hours for women. The average time from entering to leaving the ED in patients with a history of hypertension was ۳۸.۹ ± ۲۷.۱ hours, with a history of diabetes ۳۷.۶ ± ۲۷.۳ hours, and with a history of heart disease ۳۶.۵ ± ۲۴.۳ hours. It was statistically significant (p=۰.۰۰۱), (p=۰.۰۰۷) and (p=۰.۰۴۰) respectively). The difference between the average time of entering and leaving the ED with the way the patient left the emergency ward was not statistically significant (p=۰.۶۳۶). However, a statistically significant difference was observed between the average time of entering and exiting the ED with the level of triage (p=۰.۰۰۴) and the type of disease (p=۰.۰۰۱). The results of the one-way analysis of variance test showed that the difference in the average duration of hospitalization in the emergency medicine service until leaving the emergency medicine service, the difference in the average duration of assignment by emergency medicine to the visit of the specialist assistant (p=۰.۸۱۴) and the difference in the average duration of required tests From the request to the answer to the test (p=۰.۴۵۴), no significant statistical difference was observed in the age groups. However, the difference in the average time between entering and leaving the ED in the age groups was found to be statistically significant (p=۰.۰۰۱).Conclusion: The length of stay is influenced by various demographic and clinical factors. Therefore, it is possible to predict the length of stay by applying data mining techniques on hospital admission data. This work can be a suitable tool for planning and optimal allocation of hospital resources.

کلیدواژه ها:

Emergency ، Length of stay ، Hospitalization