Length of stay in EDs: variation across classifications of clinical condition and XXXX discharge disposition.

@entity1 @entity662 @entity341 @entity161 @entity293
STUDY OBJECTIVE: Duration of a stay in an @entity341 ( @entity341 ) is considered a measure of quality, but current measures average lengths of stay across all conditions. Previous research on @entity341 length of stay has been limited to a single condition or a few hospitals. We use a census of one state's data to measure length of @entity341 stays by @entity1 ' conditions and dispositions and explore differences between means and medians as quality metrics. METHODS: The data source was the Healthcare Cost and Utilization Project 2011 State Emergency Department Databases and State Inpatient Databases for Florida. Florida is unique in collecting @entity341 length of stay for both released and admitted @entity1 . Clinical Classifications Software was used to group visits based on first-listed International Classification of Disease, Ninth Edition, Clinical Modification, diagnoses. RESULTS: For the 10 most common diagnoses, @entity1 with relatively minor injuries typically required the shortest mean stay (3 hours or less); conditions resulting in admission or transfer tended to be more serious, resulting in longer stays. @entity1 requiring the longest stays, by disposition, had discharge diagnoses of nonspecific @entity662 (mean 7.4 hours among discharged @entity1 ), @entity293 (4.8 hours among admissions), and @entity161 (9.6 hours among transfers) among the top 10 diagnoses. CONCLUSION: Emergency department length of stay as a measure of @entity341 quality should take into account the considerable variation by condition and disposition of the @entity1 . Emergency department length of stay measurement could be improved in the United States by standardizing its definition; distinguishing visits involving treatment, observation, and boarding; and incorporating more distributional information.
