Factors associated with prolonged emergency department length of stay for admitted XXXX .

@entity1 @entity2613
OBJECTIVE: To estimate the prevalence of and to identify factors associated with prolonged emergency department length-of-stay ( @entity2613 -LOS) for admitted @entity1 . METHODS: Data were from the 2001-2006 National Hospital Ambulatory Medical Care Survey. The primary outcome was prolonged @entity2613 -LOS (defined as total @entity2613 time >8 hours) among admitted @entity1 . Predictor variables included @entity1 -level (eg, demographics including race/ethnicity, triage score, diagnosis, and admission to inpatient bed vs intensive care unit), physician-level (intern/resident vs attending physician), and system-level (eg, region, metropolitan area, @entity2613 and hospital type, time and season, and diagnostic and therapeutic procedures) factors. Multivariable logistic regression was performed to identify independent predictors of prolonged @entity2613 -LOS. RESULTS: Median @entity2613 -LOS for admitted @entity1 was 3.7 hours. Thirteen percent of pediatric @entity1 admitted from the @entity2613 experienced prolonged @entity2613 -LOS. Factors associated with prolonged @entity2613 -LOS for admitted @entity1 were Hispanic ethnicity (odds ratio [OR], 1.76; 95% confidence interval [95% CI], 1.10-2.81), @entity2613 arrival between midnight and 8 a.m. (OR, 2.80; 95% CI, 1.87-4.20), winter season (January-March: OR, 1.81; 95% CI, 1.20-2.74), computed tomography scan or magnetic resonance imaging (OR, 1.65; 95% CI, 1.05-2.58), and intravenous fluids or medications (OR, 1.81; 95% CI, 1.10-2.97). @entity1 requiring ICU admissions (OR, 0.29; 95% CI, 0.11-0.77) or receiving pulse oximetry in the @entity2613 (OR, 0.52; 95% CI, 0.34-0.81) had a lower risk of experiencing prolonged @entity2613 -LOS. CONCLUSIONS: We found that prolonged @entity2613 -LOS occurs frequently for admitted pediatric @entity1 and is associated with Hispanic ethnicity, presentation during winter season, and early morning arrival. Potential strategies to reduce @entity2613 -LOS include improved availability of interpreter services and enhanced staffing and additional inpatient bed availability during winter season and overnight hours.
