Time series analysis of variables associated with daily mean emergency department length of stay
Time series analysis of variables associated with daily mean emergency department length of stay
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DOI：
10.1016/j.annemergmed.2006.11.007
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发表时间：
2007-03-01
影响因子：
6.2
通讯作者：
Litvak, Eugene
中科院分区：
文献类型：
--
作者：
Rathlev, Niels K.;Chessare, John;Litvak, Eugene
研究目的：我们测量各种输入，吞吐量和输出因素对每日急诊科（艾德）平均住院时间每例patient（每日平均住院时间）的影响。方法：该研究是一项回顾性研究，2002年4月15日至2003年12月31日期间93,274艾德访问。采用自回归移动平均时间序列分析（ARIMA）评估每日平均住院时间与自变量之间的相关性。每24小时测量以下独立变量：择期手术入院人数、艾德容量、艾德入院人数、艾德ICU入院人数、艾德临床就诊时间、医院内外科占用率结果：在时间序列分析中，三个因素与每日平均住院时间独立相关：择期手术入院人数、艾德入院人数和住院人数。每增加一次择期手术，每日平均住院时间增加0.21分钟，每增加一次住院时间增加2.2分钟，住院率每增加5%，每日平均住院时间增加4.1分钟。择期手术入院与最多35小时的额外艾德留置时间相关。该模型解释了31.5%的变异，在每日平均住院时间。ARIMA分析的最终模型参数为自回归项（1）移动平均（1）。结论：医院入住率和艾德入院人数与日平均住院时间相关。每增加一次择期手术，每名艾德患者的每日平均住院时间延长0.21分钟。当日与前一日的日平均住院日存在自相关性。
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.