Factors that predict emergency department length of stay in analysis of national data

Objective This study used a nationwide database to identify and analyze factors that influence emergency department (ED) length of stay (LOS) and improve the efficiency of emergency care. Methods This retrospective study analyzed data from the National Emergency Department Information System (NEDIS) database in Korea: 25,578,263 ED visits from 2018 to 2022. Patient demographics, clinical characteristics, and ED operational variables were examined. Univariate and multivariate logistic regression analyses were used to assess the associations between the variables and prolonged ED LOS, defined as 6 hours or more. Results Among the 25,578,263 patients, the median ED LOS was 2.1 hours (interquartile range, 1.050–3.830 hours), with 12.6% experiencing a prolonged ED LOS. Elderly patients (aged ≥65 years) were significantly more likely than younger patients to experience prolonged ED LOS (adjusted odds ratio [aOR], 1.415; 95% confidence interval [CI]: 1.411–1.419). Patients transferred from other hospitals (aOR, 1.469; 95% CI, 1.463–1.474) and those arriving by emergency medical services (aOR, 1.093; 95% CI, 1.077–1.108) also had high odds of prolonged LOS. Conversely, pediatric patients had a low likelihood of extended stay (aOR, 0.682; 95% CI, 0.678–0.686). Severe illness, including sepsis (aOR, 1.324; 95% CI, 1.311–1.340) and COVID-19 infection (aOR, 1.413; 95% CI, 1.399–1.427), was strongly associated with prolonged LOS. Conclusion Prolonged ED LOS is influenced by a combination of patient demographics, clinical severity, and systemic factors. Targeted interventions for older adults, severe illness, and operational inefficiencies such as hospital transfers are essential for reducing ED LOS and improving overall emergency care delivery.

• Publication year

  2024

• Venue

  Clinical and Experimental Emergency Medicine

• Publication date

  2024-10-16

• Fields of study

  Medicine

• Identifiers
  DOI 10.15441/ceem.24.309PMID 39414332PMCID 12010807
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Emergency department utilization in elderly patients: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018-2022

  2023cited by this paper
• Epidemiologic trends of patients who visited nationwide emergency departments: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018–2022

  2023cited by this paper
• Patient and hospital characteristics predict prolonged emergency department length of stay and in-hospital mortality: a nationwide analysis in Korea

  2022cited by this paper
• The effect of COVID-19 pandemic on the length of stay and outcomes in the emergency department

  2022cited by this paper
• Association between emergency department length of stay and patient outcomes: A systematic review.

  2021cited by this paper
• Factors Associated with Emergency Department Length of Stay in Critically Ill Patients: A Single-Center Retrospective Study

  2021cited by this paper
• The effects of emergency department crowding on triage and hospital admission decisions.

  2020cited by this paper
• The effect of catastrophic health expenditure on exit from poverty among the poor in South Korea.

  2020cited by this paper
• July Phenomenon Impacts Efficiency of Emergency Care

  2018cited by this paper
• Long length of stay at the emergency department is mostly caused by organisational factors outside the influence of the emergency department: A root cause analysis

  2018cited by this paper
• The association of duration of boarding in the emergency room and the outcome of patients admitted to the intensive care unit

  2017cited by this paper
• Emergency Department Crowding Disparity: a Nationwide Cross-Sectional Study

  2016cited by this paper
• The impact of prolonged boarding of successfully resuscitated out-of-hospital cardiac arrest patients on survival-to-discharge rates.

  2015cited by this paper
• Effect of antihypertensive medication adherence on hospitalization for cardiovascular disease and mortality in hypertensive patients

  2013cited by this paper
• Emergency department overcrowding and access block.

  2013cited by this paper
• Predictors of patient length of stay in 9 emergency departments.

  2012cited by this paper
• International perspectives on emergency department crowding.

  2011cited by this paper
• The association between a prolonged stay in the emergency department and adverse events in older patients admitted to hospital: a retrospective cohort study

  2011cited by this paper
• [Participation rate and related socio-demographic factors in the national cancer screening program].

  2005cited by this paper
• Which patients spend more than 4 hours in the Accident and Emergency department?

  2004cited by this paper
• Analysis of factors influencing length of stay in the emergency department.

  2003cited by this paper
• A conceptual model of emergency department crowding.

  2003cited by this paper
• Emergency department overcrowding in the United States: an emerging threat to patient safety and public health

  2003cited by this paper
• Tying a knot in the unraveling health care safety net.

  2001cited by this paper
• The endangered safety net: establishing a measure of control.

  2001cited by this paper

• Prevalence and associated factors of prolonged emergency department length of stay among adults patients attending Wolaita Sodo University Hospital, Ethiopia: a cross-sectional study

  2026cites this paper
• Prognostic Performance of the Korean Triage and Acuity Scale Combined with the National Early Warning Score for Predicting Mortality and ICU Admission at Emergency Department Triage: A Retrospective Observational Study

  2026cites this paper
• Determinants of Emergency Department Length of Stay and the Mediation Effect of Disposition Among Injury Patients in South Korea: A Nationwide Retrospective Study.

  2026influential citation
• Characteristics and clinical outcomes of cancer patients presenting to the emergency department in Korea: a retrospective descriptive study

  2026cites this paper
• Patient and emergency department factors influencing surgery timing in patients with hip fracture

  2025cites this paper
• Epidemiological trends in emergency department visits by age group: a report from the National Emergency Department Information System (NEDIS) of Korea, 2020–2024

  2025cites this paper
• Bridging women's emergency and primary healthcare: Factors associated with prolonged obstetrics and gynecology emergency room stay in a Saudi university hospital.

  2025cites this paper
• Epidemiological trends and features of pediatric hand and elbow fractures in emergency department visits in Korea: a nationwide population-based study

  2025cites this paper
• Determinants of Emergency Department Length of Stay Using the Time Frame Emergency Care Model: A Retrospective Study

  2025cites this paper