Investigation On Prolonged Length Of Stay In Emergency Room For Critical Illness In Zhejiang Province

Objective:To investigate the detention of patients who stayed in the emergency department.16general hospitals in Zhejiang province were chosen. Our study was aiming to improve the triage process, quality of services and provide a better medical service strategy.Methods:We used a prospective cross-sectional research in our study to analysis the data including the time stayed in the emergency department (ED), the time of transporting to the ward and the time of other factors in the whole16hospitals since2012-12-07to2012-12-23. We also compared the data in various class of hospital to figure out the difference.Results:①9three-level Class A hospitals(4of them are subsidiary hospitals)and7three-level Class B hospitals were investigated.②Within7days of collecting,1728patients were accepted. The time stayed in the ED was ranging from0-350h (Median=4.5h, interquartile range=1.8-13.9h).601patients belong to subsidiary hospitals (Median=11.6h, interquartile range=2.8-24.7h).1127patients belong to un-subsidiary hospitals (Median=3.3h, interquartile range=1.7-8.3h).③There was no significant difference between the three-level Class A hospitals(un-subsidiary hospitals) and the three-level Class B hospitals. It shows an obvious difference in the time of T2(p=0.001), T3(p<0.001), T (p<0.001) between subsidiary hospitals and un-subsidiary hospitals.④3kinds of patients were presented due to their long time retention in the ED:①patients who went home by themselves②patients who managed to ordinary ward③patients who recovered and went home.⑤atients with3kinds of diseases were presented due to their long time retention in the ED:(1)patients with respiratory system disease(2)patients with multisystem disease (3)patients with circulatory system disease.⑥67.1%of the patients who stayed in the ED more than6hours is associated with the situation that there was no more place to stay in the ordinary ward.⑦The time of detention in the ER would extend the whole period in hospital according to our research.Conclusion:According to our research, look from whole, it was not so terrible for the situation that patients would be detained in the ED until2012. But it has been serious in the subsidiary hospitals. And for the patients with respiratory system disease or multisystem disease or circulatory system disease would take much more time to spend in the ED than the others. This situation was very associated with the spare place of the ordinary ward. Meanwhile we found that patients who went home by themselves and those who recovered then went home do have an impact to the situation. The main impact to the patients was detention would extend their whole period in hospital.