Gardner Rebekah L, Sarkar Urmimala, Maselli Judith H, Gonzales Ralph
Department of Medicine, University of California at San Francisco, San Francisco, CA 94143, USA.
Am J Emerg Med. 2007 Jul;25(6):643-50. doi: 10.1016/j.ajem.2006.11.037.
The aim of the study was to identify and quantify patient, physician, hospital, and system factors that are associated with a longer ED length of stay.
Data were from the 2001-2003 National Hospital Ambulatory Medical Care Survey. The primary outcome was length of stay in minutes. Predictor variables were patient level (eg, age, triage score), physician level (eg, level of training), and hospital/system level (eg, geographic location, ownership).
Admitted patients' median length of stay was 255 minutes (interquartile range, 160-400); discharged patients stayed a median of 120 minutes (interquartile range, 70-199). Factors independently associated with longer ED stays for admitted patients were Hispanic ethnicity (+20 minutes), computed tomography scan or magnetic resonance imaging (+36 minutes), and hospital location in a metropolitan area (+32 minutes). Intensive care unit admissions had a shorter length of stay (-30 minutes).
Several factors are associated with significant increases in ED length of stay and may be important factors in strategies to reduce length of stay.
本研究旨在识别并量化与急诊留观时间延长相关的患者、医生、医院及系统因素。
数据来源于2001 - 2003年国家医院门诊医疗调查。主要结局指标为以分钟计的留观时间。预测变量包括患者层面（如年龄、分诊评分）、医生层面（如培训水平）以及医院/系统层面（如地理位置、所有制）。
入院患者的中位留观时间为255分钟（四分位间距，160 - 400）；出院患者的中位留观时间为120分钟（四分位间距，70 - 199）。与入院患者急诊留观时间延长独立相关的因素包括西班牙裔种族（延长20分钟）、计算机断层扫描或磁共振成像检查（延长36分钟）以及医院位于大都市地区（延长32分钟）。入住重症监护病房的患者留观时间较短（缩短30分钟）。
若干因素与急诊留观时间显著延长相关，可能是缩短留观时间策略中的重要因素。
