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. 2012 Nov 6:12:15.
doi: 10.1186/1471-227X-12-15.

Duration of patients' visits to the hospital emergency department

Zeynal Karaca  1 , Herbert S Wong, Ryan L Mutter
Affiliations

Duration of patients' visits to the hospital emergency department

Zeynal Karaca et al. BMC Emerg Med. .

Abstract

Background: Length of stay is an important indicator of quality of care in Emergency Departments (ED). This study explores the duration of patients' visits to the ED for which they are treated and released (T&R).

Methods: Retrospective data analysis and multivariate regression analysis were conducted to investigate the duration of T&R ED visits. Duration for each visit was computed by taking the difference between admission and discharge times. The Healthcare Cost and Utilization Project (HCUP) State Emergency Department Databases (SEDD) for 2008 were used in the analysis.

Results: The mean duration of T&R ED visit was 195.7 minutes. The average duration of ED visits increased from 8 a.m. until noon, then decreased until midnight at which we observed an approximately 70-minute spike in average duration. We found a substantial difference in mean duration of ED visits (over 90 minutes) between Mondays and other weekdays during the transition time from the evening of the day before to the early morning hours. Black / African American patients had a 21.4-minute longer mean duration of visits compared to white patients. The mean duration of visits at teaching hospitals was substantially longer than at non-teaching hospitals (243.8 versus 175.6 minutes). Hospitals with large bed size were associated with longer duration of visits (222.2 minutes) when compared to hospitals with small bed size (172.4 minutes) or those with medium bed size (166.5 minutes). The risk-adjusted results show that mean duration of visits on Mondays are longer by about 4 and 9 percents when compared to mean duration of visits on non-Monday workdays and weekends, respectively.

Conclusions: The duration of T&R ED visits varied significantly by admission hour, day of the week, patient volume, patient characteristics, hospital characteristics and area characteristics.

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Figures

Figure 1
Figure 1
Duration of treat-and-release visits at emergency departments by hour. Data includes all treat-and-release emergency visits during 2008 in Arizona, Massachusetts and Utah. Duration is measured in minutes as the difference between admission time and discharge time for each visit.
Figure 2
Figure 2
Duration of treat-and-release visits at emergency departments of teaching hospitals by hour. Data includes all treat-and-release emergency visits during 2008 in Arizona, Massachusetts and Utah. Duration is measured in minutes as the difference between admission time and discharge time for each visit.
Figure 3
Figure 3
Duration of treat-and-release visits at emergency departments of non-profit hospitals by hour. Data includes all treat-and-release emergency visits during 2008 in Arizona, Massachusetts and Utah. Duration is measured in minutes as the difference between admission time and discharge time for each visit.
Figure 4
Figure 4
Duration of treat-and-release visits at emergency departments of for-profit hospitals by hour. Data includes all treat-and-release emergency visits during 2008 in Arizona, Massachusetts and Utah. Duration is measured in minutes as the difference between admission time and discharge time for each visit.
Figure 5
Figure 5
Duration of treat-and-release visits at emergency departments of public hospitals by hour. Data includes all treat-and-release emergency visits during 2008 in Arizona, Massachusetts and Utah. Duration is measured in minutes as the difference between admission time and discharge time for each visit.
Figure 6
Figure 6
Duration of treat-and-release visits at emergency departments on Mondays by hour. Data includes all treat-and-release emergency visits during 2008 in Arizona, Massachusetts and Utah. Duration is measured in minutes as the difference between admission time and discharge time for each visit.
Figure 7
Figure 7
Duration of treat-and-release visits at emergency departments on Non-Monday weekdays by hour. Data includes all treat-and-release emergency visits during 2008 in Arizona, Massachusetts and Utah. Duration is measured in minutes as the difference between admission time and discharge time for each visit.
Figure 8
Figure 8
Duration of treat-and-release visits at emergency departments on weekends by hour. Data includes all treat-and-release emergency visits during 2008 in Arizona, Massachusetts and Utah. Duration is measured in minutes as the difference between admission time and discharge time for each visit.
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