ANALYSIS OF CLINICAL COMPLEXITY, HOSPITAL CAPACITY, AND INTER-UNIT COORDINATION ON LENGTH OF STAY OF PATIENTS IN EMERGENCY DEPARTMENT AT HOSPITAL

Abstract

Background: The Emergency Department (ED) is a critical service unit that serves as the primary gateway for hospital care for patients with emergency conditions. One of the quality indicators of ED services is Length of Stay (LOS), which refers to the duration of time a patient remains in the ED from arrival until discharge or transfer to another unit. Prolonged LOS can lead to overcrowding, reduce the quality of healthcare services, and increase clinical risks for patients. Several factors are suspected to influence LOS in the ED, including patient clinical complexity, hospital capacity, and coordination among service units. Objective: This study aims to analyze the effect of clinical complexity, hospital capacity, and inter-unit coordination on patient Length of Stay in the Emergency Department of Hospital X. Methods: This study employed a quantitative analytic observational design using a cross-sectional approach. Data were obtained from the medical records of patients who visited the Emergency Department of Hospital X. The total sample in this study consisted of 297 respondents selected using purposive sampling. Multivariate analysis was performed using multiple linear regression to identify the most dominant factors influencing the Length of Stay (LOS) of patients in the Emergency Department, with a significance level of p < 0.05.. Results: The results showed a significant relationship between clinical complexity and patient Length of Stay in the Emergency Department (up = 0.036), hospital capacity and Length of Stay (p = 0.025), and inter-unit coordination and Length of Stay (p = 0.004). Multivariate analysis indicated that these three variables simultaneously had a significant effect on the Length of Stay of ED patients (F = 2.983; p = 0.032). Conclusion: Clinical complexity, hospital capacity, and inter-unit coordination significantly influence the Length of Stay (LOS) of patients in the Emergency Department, with inter-unit coordination identified as the most dominant factor contributing to prolonged LOS. Therefore, hospitals should prioritize strengthening inter-unit coordination through effective communication, integrated systems, and optimized capacity management to improve patient flow and reduce LOS.