Length of stay in the emergency department and its associated input-, throughput-, and output factors at two hospitals in Sweden

Abstract Background Prolonged emergency department length of stay (EDLOS) is a worldwide issue associated with increased mortality, decreased patient satisfaction and poor quality of care. The factors influencing EDLOS have not been comprehensively studied in the context of Swedish EDs. This study’s...

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Main Authors: Jonas Andersson, Lisa Kurland, Lena Nordgren, Annelie K. Gusdal, Ivy Cheng
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Emergency Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12873-025-01283-z
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author Jonas Andersson
Lisa Kurland
Lena Nordgren
Annelie K. Gusdal
Ivy Cheng
author_facet Jonas Andersson
Lisa Kurland
Lena Nordgren
Annelie K. Gusdal
Ivy Cheng
author_sort Jonas Andersson
collection DOAJ
description Abstract Background Prolonged emergency department length of stay (EDLOS) is a worldwide issue associated with increased mortality, decreased patient satisfaction and poor quality of care. The factors influencing EDLOS have not been comprehensively studied in the context of Swedish EDs. This study’s objective is to determine the input-, throughput- and output factors associated with EDLOS, at two urban EDs in Sweden. Methods Data was collected from two hospitals. All patient visits during the two-year study period were included. Patients who left without being seen by a physician were excluded. The explanatory factors included patient characteristics, medical data, and hospital bed occupancy data. Multi-variable linear regression analysis was used to test the associations between the factors and EDLOS. Results The top contributors to prolonged EDLOS were diagnostic imaging, which added between 64 and 149 min of EDLOS, diagnostic testing at central laboratory (53–99 min), followed by intra-ED zone transfer (46–94 min). Arriving during crowding or being admitted during high hospital bed occupancy had a significant but relatively small absolute effect on the outcome. Conclusions Throughput factors had far greater impact on EDLOS than both input- and output factors. Adapting strategies to the structural and procedural characteristics of each setting may enhance the effectiveness of improvement efforts. Clinical trial number Not applicable.
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issn 1471-227X
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series BMC Emergency Medicine
spelling doaj-art-c64fd17043264dd597c8d84396df7cd22025-08-20T03:45:52ZengBMCBMC Emergency Medicine1471-227X2025-07-0125111110.1186/s12873-025-01283-zLength of stay in the emergency department and its associated input-, throughput-, and output factors at two hospitals in SwedenJonas Andersson0Lisa Kurland1Lena Nordgren2Annelie K. Gusdal3Ivy Cheng4School of Medical Sciences, Örebro UniversitySchool of Medical Sciences, Örebro UniversityDepartment of Public Health and Caring Sciences, Centre for Clinical Research Sörmland, Uppsala UniversitySchool of Health, Care and Social Welfare, Mälardalen UniversitySchool of Medical Sciences, Örebro UniversityAbstract Background Prolonged emergency department length of stay (EDLOS) is a worldwide issue associated with increased mortality, decreased patient satisfaction and poor quality of care. The factors influencing EDLOS have not been comprehensively studied in the context of Swedish EDs. This study’s objective is to determine the input-, throughput- and output factors associated with EDLOS, at two urban EDs in Sweden. Methods Data was collected from two hospitals. All patient visits during the two-year study period were included. Patients who left without being seen by a physician were excluded. The explanatory factors included patient characteristics, medical data, and hospital bed occupancy data. Multi-variable linear regression analysis was used to test the associations between the factors and EDLOS. Results The top contributors to prolonged EDLOS were diagnostic imaging, which added between 64 and 149 min of EDLOS, diagnostic testing at central laboratory (53–99 min), followed by intra-ED zone transfer (46–94 min). Arriving during crowding or being admitted during high hospital bed occupancy had a significant but relatively small absolute effect on the outcome. Conclusions Throughput factors had far greater impact on EDLOS than both input- and output factors. Adapting strategies to the structural and procedural characteristics of each setting may enhance the effectiveness of improvement efforts. Clinical trial number Not applicable.https://doi.org/10.1186/s12873-025-01283-zEmergency departmentLength of stayExplanatory factorsPatient flow
spellingShingle Jonas Andersson
Lisa Kurland
Lena Nordgren
Annelie K. Gusdal
Ivy Cheng
Length of stay in the emergency department and its associated input-, throughput-, and output factors at two hospitals in Sweden
BMC Emergency Medicine
Emergency department
Length of stay
Explanatory factors
Patient flow
title Length of stay in the emergency department and its associated input-, throughput-, and output factors at two hospitals in Sweden
title_full Length of stay in the emergency department and its associated input-, throughput-, and output factors at two hospitals in Sweden
title_fullStr Length of stay in the emergency department and its associated input-, throughput-, and output factors at two hospitals in Sweden
title_full_unstemmed Length of stay in the emergency department and its associated input-, throughput-, and output factors at two hospitals in Sweden
title_short Length of stay in the emergency department and its associated input-, throughput-, and output factors at two hospitals in Sweden
title_sort length of stay in the emergency department and its associated input throughput and output factors at two hospitals in sweden
topic Emergency department
Length of stay
Explanatory factors
Patient flow
url https://doi.org/10.1186/s12873-025-01283-z
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