Studying The Impacts of Occupancy Rate on Length of Stay and Outcomes At The Emergency Department At The Regina General Hospital

Date
2019-03
Authors
Al Mashalah, Heider Abdul Majid Abdalkarim
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Faculty of Graduate Studies and Research, University of Regina
Abstract

The emergency department at Regina General Hospital typically experiences high occupancy rates. This has serious implications. The following thesis addresses the impact of high occupancy rates on length of stay, the odds ratio of bounce-back, mortality, and leaving without being seen. Quantile regression is used to analyze the association between occupancy rate and length of stay at the emergency department. It is also utilized to capture the effect of occupancy rate and length of stay during index visit, and return visit. In addition, Wilcoxon rank sum test is used to compare the median value of length of stay in return visit versus index visit. Multivariable logistic regression is implemented to find the impact of occupancy rate and length of stay on the odds ratios of bounce-back, mortality, and leaving without being seen. Occupancy rate variable increases length of stay by 0.88 hour. Additionally, it increases the odds ratio of leaving without being seen by 10.8. A one per cent increase in length of stay increases the odds ratio of bounce-back by 0.11%. It also reduces the odds ratio of LWBS by 1.2% for patients diagnosed with abdominal main problem, and 1.7% for patients diagnosed with other medical problems. Length of stay in index visit increases the length of stay in return visit by 0.3 hours; the median value of length of stay, however, is greater in index visit compared to the median value in return visit. It seems unlikely that an increase of one hour in length of stay might reduce the odds ratio of inpatient mortality by 0.02; the finding is questionable because of model validity due to a few death records. Overall results indicate that occupancy rate impacts both length of stay and leaving without been seen. Length of stay is also a strong predictor for bounce-back and leaving without being seen.

Description
A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Master of Applied Science in Industrial Systems Engineering, University of Regina. xi, 169 p.
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