Motimele L, Lalloo V, Sefala T, Engelbrecht A, Majake-Mogoba L, Basu D
Steve Biko Academic Hospital, Gauteng Province, South Africa.
Department of Public Health Medicine, School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South Africa.
Afr J Emerg Med. 2025 Dec;15(4):100896. doi: 10.1016/j.afjem.2025.100896. Epub 2025 Aug 27.
Length of stay (LOS) is an integral part of inpatient care in hospitals, particularly in Emergency Departments (EDs). It is an essential performance indicator for the National Indicator Data Set in South Africa. Multiple studies have indicated a correlation between an increased LOS and worse patient outcomes in a variety of acute medical conditions. The study aims to establish the key factors of LOS in the ED at a central hospital in the Gauteng Province of South Africa.
A cross-sectional study was conducted over seventeen months (Aug 2023 to Dec 2024) based on 2927 entries of patients admitted at the ED for more than 48 hours. No intervention was done as part of this study.
The median LOS was 2.81 days (IQR: 2-3) with a minimum of 2 days and a maximum of 12 days. A regression analysis demonstrated that the most significant determinants for prolonged LOS were gender and disease group of boarded patients awaiting ward transfer.Significant differences (p < 0.001) in the LOS between clinical disciplines were noted, with medical (45%) and surgical departments (46%) accounting for most boarding patients compared to all other clinical disciplines.
Data demonstrated that 80% of patients in the ED wait an average of 3 days before transfer into the wards. This extended ALOS in the ED has consequences for patient outcomes and the quality of healthcare provided. Based on the findings of this study, strategies to improve patient flow are essential in facilitating timeous discharge from wards and to prioritise the forward flow of patients waiting in ED.
住院时间（LOS）是医院住院护理的一个组成部分，在急诊科（EDs）尤为如此。它是南非国家指标数据集的一项重要绩效指标。多项研究表明，在各种急性医疗状况下，住院时间延长与患者预后较差之间存在关联。本研究旨在确定南非豪登省一家中心医院急诊科住院时间的关键因素。
基于急诊科收治48小时以上患者的2927条记录，进行了为期17个月（2023年8月至2024年12月）的横断面研究。本研究未进行任何干预。
住院时间中位数为2.81天（四分位间距：2 - 3天），最短2天，最长12天。回归分析表明，等待病房转移的留观患者的性别和疾病组是住院时间延长的最显著决定因素。各临床学科之间的住院时间存在显著差异（p < 0.001），与所有其他临床学科相比，内科（45%）和外科（46%）的留观患者最多。
数据表明，急诊科80%的患者平均等待3天才能转入病房。急诊科这种延长的平均住院时间对患者预后和所提供的医疗质量产生影响。基于本研究结果，改善患者流程的策略对于促进及时从病房出院以及优先处理急诊科等待的患者向前流转至关重要。
