TITLE:
Emergency Department Waiting Times and Determinants of Prolonged Length of Stay in a Botswana Referral Hospital
AUTHORS:
Keatlaretse Siamisang, John Thato Tlhakanelo, Bonolo Bonnie Mhaladi
KEYWORDS:
Emergency Department, Waiting Times, Prolonged Length of Stay, Determinants
JOURNAL NAME:
Open Journal of Emergency Medicine,
Vol.8 No.3,
July
23,
2020
ABSTRACT: Introduction: Emergency medicine is a critical component of quality public health
service. In fact length of stay and waiting times in the Emergency department
are key indicators of quality. The aim of this study was to determine waiting times and determinants of prolonged length
of stay (LOS) in the Princess Marina Hospital Emergency Department. Methods: This was a retrospective observational study. It was done at Princess
Marina, a referral hospital in Gaborone,
Botswana. Triage forms of patients who presented between 19/11/ 2018 and 18/12/2018 were
reviewed. Data from patient files was used to determine time duration from
triage to being reviewed by a doctor, time duration from review by emergency
doctor to patients’ disposition and the time duration
from patient’s triage to disposition (length of stay). Prolonged length of stay was defined as duration > 6 hours. Results: A total of 1052 files repre- senting patients seen over a 1-month period were
reviewed. 72.5% of the patients had a prolonged length of stay. The median
emergency doctor waiting time was 4.5 hours (IQR 1.6 - 8.3 hours) and the
maximum was 27.1 hours. The median length of stay in the emergency department
was 9.6 hours (IQR 5.8 - 14.6 hours) and the maximum was 45.9 hours. Patient’s age (AOR 1.01), mental status
(AOR 0.61), admission to internal medicine service (AOR 5.12) and pediatrics admissions (AOR 0.11) were
significant predictors of prolonged length
of stay in the emergency department. Conclusion: Princess Marina Hospital emergency department waiting times and length of stay are long. Age, normal mental
status and internal medicine admission were independent predictors of prolonged
stay (>6 hours). Admission to the pediatrics service was associated with
shorter length of stay. There is a need for interventions to address the long waiting times and length of stay.
Interventions should particularly focus on the identified predictors.