与急诊科住院时间相关因素的最新范围审查。

IF 2.7 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Journal of Multidisciplinary Healthcare Pub Date : 2025-06-04 eCollection Date: 2025-01-01 DOI:10.2147/JMDH.S525451
Kurhayati Kurhayati, Etika Emaliyawati, Yanny Trisyani
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引用次数: 0

摘要

背景:急诊科(ED)是医院医疗保健系统的重要组成部分。然而,越来越多的病人到急诊室就诊,增加了住院时间(LOS),这有助于过度拥挤,资源限制和护理质量下降。影响LOS的因素很复杂,涉及患者特征、医院操作和卫生系统政策。目的:探讨影响ED LOS的因素。方法:本研究采用PRISMA-ScR方法进行范围综述,分析了PubMed、Scopus、Taylor & Francis和EBSCOhost数据库在2022年至2025年间发表的文章。使用的关键词是急诊科患者或急诊科患者或住院人数或急诊人数、住院时间或住院时间以及预测因子或因素。文章的质量评估使用乔安娜布里格斯研究所的关键评估工具进行评估。数据分析采用描述性定性分析和专题分析。结果:影响急诊科患者LOS的因素主要分为5类:(1)患者特征(高龄、男性、合并症、败血症、血液病等特殊临床情况);(2)时间和环境因素(夜间、周末、冬季访问);(3)医院和卫生系统因素(医院类型、床位容量、保险状况、分诊严重程度);(4)诊断和治疗过程(放射和实验室检查的等待时间、专科会诊的延误和住院床位有限);(5)病人到达模式(由救护车到达或从其他医院转介)。结论:ED患者较长的LOS受多种多维因素的影响,这些因素相互作用。为了减少病人在急诊科的停留时间,需要努力优化分诊,提高诊断效率,加强医院单位之间的协调。基于证据的策略,如数字化医疗记录和预测分析,可以帮助提高服务效率,减少急诊室的拥堵。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
An Updated Scoping Review of Factors Associated with Length of Stay in Emergency Department.

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.

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来源期刊
Journal of Multidisciplinary Healthcare
Journal of Multidisciplinary Healthcare Nursing-General Nursing
CiteScore
4.60
自引率
3.00%
发文量
287
审稿时长
16 weeks
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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