Abstract:
Background: Hospital long stay is a serious social and economic problem, leading to elevated medical expenses and dissatisfaction, and increased workload and financial burden. Patients discharge time was different in admitted patients in hospitals. In Ethiopia, there were limited evidence why the patients' length of stay is different in roughly the same condition.
Objective: The aims of this study were to determine time to discharge and its predictors among admissions in Felege Hiwot hospital in Bahir Dar, northwest Ethiopia, 2020 G.C
Methods: Prospective cohort study was conducted among 812 systematically selected study participants. The data was collected by well-trained data collectors and supervisors using check list. Then entered into EpiData Version 3.1, and exported into Stata version 15. Median, range of age and proportion of respondents were stated. Incidence density to estimate time to discharge. Life table and Kaplan Meier curve to determine the cumulative survival of patients in the wards were used. Cox proportional hazard (Weibull) model was used to investigate predictors of discharge. Variables from bivariate analysis with p<0.25 were candidate for final model. Adjusted Hazard Ratio with their 95% CI at p<0.05 used to predict discharge. Model fitness was diagnosed. Results: A total of 812 (408 from medical ward and 404 from surgical ward) admitted patients participated in the study giving total response rate of 95%. Fifty-five percent were females; median age was 32. The total times at risk/admission in medical wards were 1802and in surgical wards
2074 days. The incidence densities of discharge in medical and surgical wards were 364/1803 (2019/10000)-person days and 356/2074 (1716/10000)-person days respectively. Median time to discharge of all participant admission was four days. Median discharge time was five days in medical and four days in surgical ward. Predictors of discharge were age (AHR 1.04(95% CI 1,02-
1.06)), family care (AHR .69(.51-.94)), admission source (AHR 2.07(1.39-2.90)), admission time
(AHR .57(.49-.67)). Lab.-result delay (AHR .67(.55-.81)), radiological result delay (AHR .78 (.64-
.95)), comorbidity (AHR.50(.42-.60)), disease burden group (AHR 2.15(1.84-2.66)), specialty (AHR 0.66 (0.56-0.78)), nurse-to-patient ratio (AHR 1.95 (1.57-2.43)), and medication adherence (AHR 2.83(2.29-3.51).
Conclusion: Generally surgical admitted patients discharged in longer time than medical even median time of surgical was less than medical. It is important to emphasize on good communication of respective specialty on lab and radiology result test waiting time and also teaching the benefit of medication adherence to the patients.
Key-words; admission, length of stay, inpatients.