Relevance of using length of stay as a key indicator to monitor emergency department performance: Case study from a rural hospital in Thailand

Emergency Medicine Australasia : EMA
Paibul SuriyawongpaisalThanita Thongtan

Abstract

The present study explores factors related to length of stay (LOS) in a rural public hospital in Thailand and assesses the feasibility of using LOS as an ED key performance indicator. Using a mixed-methods approach, qualitative methods (in-depth interviews, patients' chart review and participatory observations) were used to guide and elaborate findings from quantitative analysis of 555 electronic ED records. Multivariate analysis revealed that age, Emergency Severity Index score and number of laboratory tests were significantly associated with LOS. The qualitative approach provided contradicting evidence on the linkage between LOS and patient outcomes. On the one hand, considering the 4 h rule, a child with asthma was referred to a tertiary care hospital because of deterioration after 4 h of ED care. On the other hand, a woman with sepsis was hospitalised with improved condition despite 7 h of ED care. Interviews revealed the waiting time to see doctors was probably the top priority issue for patients. Factors related to LOS in a rural hospital in Thailand are similar and in contrast to those of a previous study in a medical school setting. Reasons for the discrepancy of findings and implications for improving ED services were ...Continue Reading

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Citations

Mar 23, 2019·The International Journal of Health Planning and Management·Muhammed OrduChris Tofallis
Dec 15, 2020·BMJ Open·Loren De FreitasSeetharaman Hariharan

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