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Time series analysis of variables associated with daily mean emergency department length of stay.
Ann Emerg Med. 2007 Mar; 49(3):265-71.AE

Abstract

STUDY OBJECTIVE

We measure the effect of various input, throughput, and output factors on daily emergency department (ED) mean length of stay per patient (daily mean length of stay).

METHODS

The study was a retrospective review of 93,274 ED visits between April 15, 2002, and December 31, 2003. The association between the daily mean length of stay and the independent variables was assessed with autoregressive moving average time series analysis (ARIMA). The following independent variables were measured per 24-hour period: number of elective surgical admissions, ED volume, number of ED admissions, number of ED ICU admissions, number of ED clinical attending hours, hospital medical-surgical occupancy (hospital occupancy), and day of the week.

RESULTS

Three factors were independently associated with daily mean length of stay in time series analysis: number of elective surgical admissions, number of ED admissions, and hospital occupancy. The daily mean length of stay increased by 0.21 minutes for every additional elective surgical admission, 2.2 minutes for every additional admission, and 4.1 minutes for every 5% increase in hospital occupancy. Elective surgical admissions were associated with a maximum of 35 hours of additional ED dwell time. The model accounted for 31.5% of the variability in daily mean length of stay. The final model parameters for the ARIMA analysis were autoregressive term (1) moving average (1).

CONCLUSION

Hospital occupancy and the number of ED admissions are associated with daily mean length of stay. Every additional elective surgical admission prolonged the daily mean length of stay by 0.21 minutes per ED patient. Autocorrelation exists between the daily mean length of stay of the current day and the previous day.

Authors+Show Affiliations

Department of Emergency Medicine, Boston Medical Center, One Boston Medical Center Place, Boston, MA 02118, USA. nrathlev@bu.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17224203

Citation

Rathlev, Niels K., et al. "Time Series Analysis of Variables Associated With Daily Mean Emergency Department Length of Stay." Annals of Emergency Medicine, vol. 49, no. 3, 2007, pp. 265-71.
Rathlev NK, Chessare J, Olshaker J, et al. Time series analysis of variables associated with daily mean emergency department length of stay. Ann Emerg Med. 2007;49(3):265-71.
Rathlev, N. K., Chessare, J., Olshaker, J., Obendorfer, D., Mehta, S. D., Rothenhaus, T., Crespo, S., Magauran, B., Davidson, K., Shemin, R., Lewis, K., Becker, J. M., Fisher, L., Guy, L., Cooper, A., & Litvak, E. (2007). Time series analysis of variables associated with daily mean emergency department length of stay. Annals of Emergency Medicine, 49(3), 265-71.
Rathlev NK, et al. Time Series Analysis of Variables Associated With Daily Mean Emergency Department Length of Stay. Ann Emerg Med. 2007;49(3):265-71. PubMed PMID: 17224203.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Time series analysis of variables associated with daily mean emergency department length of stay. AU - Rathlev,Niels K, AU - Chessare,John, AU - Olshaker,Jonathan, AU - Obendorfer,Dan, AU - Mehta,Supriya D, AU - Rothenhaus,Todd, AU - Crespo,Steven, AU - Magauran,Brendan, AU - Davidson,Kathy, AU - Shemin,Richard, AU - Lewis,Keith, AU - Becker,James M, AU - Fisher,Linda, AU - Guy,Linda, AU - Cooper,Abbott, AU - Litvak,Eugene, Y1 - 2007/01/16/ PY - 2005/10/28/received PY - 2006/10/13/revised PY - 2006/11/02/accepted PY - 2007/1/17/pubmed PY - 2007/3/16/medline PY - 2007/1/17/entrez SP - 265 EP - 71 JF - Annals of emergency medicine JO - Ann Emerg Med VL - 49 IS - 3 N2 - STUDY OBJECTIVE: We measure the effect of various input, throughput, and output factors on daily emergency department (ED) mean length of stay per patient (daily mean length of stay). METHODS: The study was a retrospective review of 93,274 ED visits between April 15, 2002, and December 31, 2003. The association between the daily mean length of stay and the independent variables was assessed with autoregressive moving average time series analysis (ARIMA). The following independent variables were measured per 24-hour period: number of elective surgical admissions, ED volume, number of ED admissions, number of ED ICU admissions, number of ED clinical attending hours, hospital medical-surgical occupancy (hospital occupancy), and day of the week. RESULTS: Three factors were independently associated with daily mean length of stay in time series analysis: number of elective surgical admissions, number of ED admissions, and hospital occupancy. The daily mean length of stay increased by 0.21 minutes for every additional elective surgical admission, 2.2 minutes for every additional admission, and 4.1 minutes for every 5% increase in hospital occupancy. Elective surgical admissions were associated with a maximum of 35 hours of additional ED dwell time. The model accounted for 31.5% of the variability in daily mean length of stay. The final model parameters for the ARIMA analysis were autoregressive term (1) moving average (1). CONCLUSION: Hospital occupancy and the number of ED admissions are associated with daily mean length of stay. Every additional elective surgical admission prolonged the daily mean length of stay by 0.21 minutes per ED patient. Autocorrelation exists between the daily mean length of stay of the current day and the previous day. SN - 1097-6760 UR - https://www.unboundmedicine.com/medline/citation/17224203/Time_series_analysis_of_variables_associated_with_daily_mean_emergency_department_length_of_stay_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-0644(06)02528-5 DB - PRIME DP - Unbound Medicine ER -