For example, a patient presented to the emergency department on August 29, but a room in the floor (a medical inpatient ward) was not available until August 31. As such, the latter date was recorded as the date of admission in the patient's medical record even though the patient has been occupying a bed in the emergency department. So, if you're collecting the data of such patient, which date would you record as the date of admission in order to start counting the length of hospital stay?
It depends on what it is you are trying to study. If you are trying to study, say, the rate of DVT in a specific inpatient ward, it makes more sense to count the date of the patient going up to the floor, but if it is something related to a disease/patient itself, say, length of stay for ketoacidosis, it would be better to record the date of presentation to the ED. If you are building a database, I'd advise you to either determine what is relevant for your study before you start building the database, or if you are unsure of what might be relevant for your study or even future studies, record both dates (it is better to have it and not need it than to need it and not have it). Generally speaking, if it has to to with a disease's natural hystory or effect of treatment, then it is better to count from the ED admission date, because how long it takes for the patient to go up to the floor depends on many other factors. If it has to do with healthcare managemet and quality and safety research into a specific ward, in some situations, it may be better to count form the date of admission to that specific ward.
Also, sometimes it may be better to also record the time of the admission, as someone that is admited to the ED at 11pm and gets discharged at 1pm the next day, stayed in hospital for 14 hours, not 2 days. However, if the stay is more prolonged, then factors such as weekends, availability of lab tests and imaging, ... may affect how long the patient is in hospital and in those scenarios, it isn't really that important to record the time of admission.
Hope this helps Abrar Thabit.
Hi Abrar,
I would include both dates. I agree with Nuno that it depends on your research objective. However, if you wish to demonstrate the impact of bed availability on patient outcomes, you will need to consider the time spent in ED. Occupying a bed in the ED has service and financial implications that may be greater or less than that of the ward. Consider the length of stay in ED (at least 2 days in your example) and what was the impact compared to patients admitted to a ward bed in a shorter time.
If you wish to demonstrate the real LOS use the first date, but you will also nneed the second date to demonstrate that there is a problem. See my series on hospital bed numbers and occupancy at http://www.hcaf.biz/2010/Publications_Full.pdf
- Badges
- Science topic