{"title":"An Updated Scoping Review of Factors Associated with Length of Stay in Emergency Department.","authors":"Kurhayati Kurhayati, Etika Emaliyawati, Yanny Trisyani","doi":"10.2147/JMDH.S525451","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The Emergency Department (ED) is important to the hospital healthcare system. However, increasing patient visits to the ED have increased the length of stay (LOS), which contributes to overcrowding, resource constraints, and decreased quality of care. Factors affecting LOS are complex and involve patient characteristics, hospital operations, and health system policies.</p><p><strong>Purpose: </strong>This review aimed to explore the factors influencing ED LOS.</p><p><strong>Methods: </strong>This study employed a scoping review with the PRISMA-ScR approach, analyzing articles from PubMed, Scopus, Taylor & Francis, and EBSCOhost databases published between 2022 and 2025. The keywords used were Emergency department patients OR ED patients OR Hospital admissions OR Emergency visits AND Length of stay OR hospital stay AND Predictor OR Factor. The quality appraisal of the articles was assessed using the Joanna Briggs Institute critical evaluation tool. Data were analyzed using descriptive qualitative and thematic analysis.</p><p><strong>Results: </strong>Factors influencing LOS in the ED were categorized into five main categories: (1) Patient characteristics (advanced age, male gender, comorbidities, and specific clinical conditions such as sepsis and blood diseases); (2) Time and environmental factors (nighttime, weekend, and winter visits); (3) Hospital and health system factors (hospital type, bed capacity, insurance status, and triage severity); (4) Diagnostic and treatment processes (waiting times for radiology and laboratory examinations, delays in specialist consultations, and limited inpatient beds); and (5) Patient arrival mode (arriving by ambulance or referred from another hospital).</p><p><strong>Conclusion: </strong>Longer LOS in the ED is influenced by various multidimensional factors that interact with each other. To reduce patient stays in the ED, efforts to optimize triage, improve diagnostic efficiency, and strengthen coordination between hospital units are needed. Evidence-based strategies such as digitizing medical records and predictive analytics can help improve service efficiency and reduce ED congestion.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3191-3203"},"PeriodicalIF":2.7000,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146896/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Multidisciplinary Healthcare","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/JMDH.S525451","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The Emergency Department (ED) is important to the hospital healthcare system. However, increasing patient visits to the ED have increased the length of stay (LOS), which contributes to overcrowding, resource constraints, and decreased quality of care. Factors affecting LOS are complex and involve patient characteristics, hospital operations, and health system policies.
Purpose: This review aimed to explore the factors influencing ED LOS.
Methods: This study employed a scoping review with the PRISMA-ScR approach, analyzing articles from PubMed, Scopus, Taylor & Francis, and EBSCOhost databases published between 2022 and 2025. The keywords used were Emergency department patients OR ED patients OR Hospital admissions OR Emergency visits AND Length of stay OR hospital stay AND Predictor OR Factor. The quality appraisal of the articles was assessed using the Joanna Briggs Institute critical evaluation tool. Data were analyzed using descriptive qualitative and thematic analysis.
Results: Factors influencing LOS in the ED were categorized into five main categories: (1) Patient characteristics (advanced age, male gender, comorbidities, and specific clinical conditions such as sepsis and blood diseases); (2) Time and environmental factors (nighttime, weekend, and winter visits); (3) Hospital and health system factors (hospital type, bed capacity, insurance status, and triage severity); (4) Diagnostic and treatment processes (waiting times for radiology and laboratory examinations, delays in specialist consultations, and limited inpatient beds); and (5) Patient arrival mode (arriving by ambulance or referred from another hospital).
Conclusion: Longer LOS in the ED is influenced by various multidimensional factors that interact with each other. To reduce patient stays in the ED, efforts to optimize triage, improve diagnostic efficiency, and strengthen coordination between hospital units are needed. Evidence-based strategies such as digitizing medical records and predictive analytics can help improve service efficiency and reduce ED congestion.
期刊介绍：
The Journal of Multidisciplinary Healthcare (JMDH) aims to represent and publish research in healthcare areas delivered by practitioners of different disciplines. This includes studies and reviews conducted by multidisciplinary teams as well as research which evaluates or reports the results or conduct of such teams or healthcare processes in general. The journal covers a very wide range of areas and we welcome submissions from practitioners at all levels and from all over the world. Good healthcare is not bounded by person, place or time and the journal aims to reflect this. The JMDH is published as an open-access journal to allow this wide range of practical, patient relevant research to be immediately available to practitioners who can access and use it immediately upon publication.
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