Emergency department length of stay independently predicts excess inpatient length of stay

OBJECTIVE: To examine the association between emergency department length of stay (EDLOS) and inpatient length of stay (IPLOS). DESIGN: Retrospective review of presentations and admissions data. SETTING: Three metropolitan hospitals in Melbourne, 1 July 2000 to 30 June 2001. MAIN OUTCOME MEASURES: Mean IPLOS for four categories of EDLOS (12 hours); excess IPLOS, defined as IPLOS exceeding state average length of stay; odds ratios for excess IPLOS adjusted for age, sex and time of presentation. RESULTS: 17 954 admissions were included. Mean IPLOS for the four categories of EDLOS were 12 hours, 7.20 days (P 12 hours, 1.49 (1.36-1.63), after adjusting for elderly status, sex and time of ED presentation. CONCLUSION: EDLOS correlates strongly with IPLOS, and predicts whether IPLOS exceeds the state benchmark for the relevant diagnosis-related group, independently of elderly status, sex and time of presentation to ED. Strategies to reduce EDLOS (including countering access block) may significantly reduce healthcare expenditure and patient morbidity.