Factors associated with emergency department length of stay of foreign patients visiting a regional core hospital in Japan

Abstract

Aim This study aims to elucidate the foreign patient‐specific factors associated with emergency department length of stay (EDLOS) in a regional core hospital emergency department (ED) in Japan. Methods This retrospective observational study included non‐Japanese patients who visited the ED in a Japanese regional core hospital between April 1, 2018, and March 31, 2020. The effects on EDLOS were assessed using multivariate linear regression analysis, which included factors such as age, sex, consultation language, interpreter usage, arrival time, day of visit, mode of arrival, underlying disease, triage level, diagnosis of injury/noninjury, diagnostic investigations, consultation with specialists, and treatments or procedures. Results Of 65,297 ED patients, there were 777 study patients, with a median age of 37 years (interquartile range [IQR], 24.0–50.0). The median EDLOS was 101 min (IQR, 63.0–153.0). Multivariate linear regression analysis indicated that an extended EDLOS was associated with: language apart from Japanese, Chinese, or English (51.7 min; 95% confidence interval [CI], 17.8–85.6), helicopter arrival (115.6 min; 95% CI, 48.8–182.5), blood testing (60.5 min; 95% CI, 34.6–86.4), computed tomography (23.8 min; 95% CI, 3.7–43.9), consultation with specialists (36.2 min; 95% CI, 11.8–60.6), intravenous fluid/medication (29.7 min; 95% CI, 3.3–56.1), and surgical procedure/reduction/fixation in the ED (38.8 min; 95% CI, 14.2–63.4). Conclusions Consultation in a language other than Japanese, English, or Chinese was associated with a longer EDLOS in a regional core hospital in Japan. Devising ways to accommodate patients who speak various languages could be important.

Keywords

• Communication barrier
• emergency treatment
• internationality
• length of stay
• quality of health care