title: Reasons for delay in inpatient admission at an emergency department.
abstract: OBJECTIVE
  This study highlighted the reasons which contributed to longer stay of patients in Emergency Department (ED) who were advised admission.
  
  
  METHODS
  This study was conducted from August 4 to 11, 2004G as a retrospective review of the ED cards of patients admitted to inpatients wards of Al-Noor Specialist Hospital, Makkah, Saudi Arabia. The demographic data, doctors & nurses notes with their timings were reviewed. The maximum consumed time by a reason was considered as the main reason of delay for that subject. The delayed patients were divided into Group A and B, delayed before and after admission was advised, respectively. Prolonged length of stay (Delay) in ED was defined as stay longer than 2 hours after patient's arrival in ED until they were received to wards.
  
  
  RESULTS
  Out of total 4876 visits during study period, 355 (7.3%) patients were admitted, and 238 (67%) were delayed. Age group 13-30 years was common in delayed 78 (32.8%) and not delayed 56 (47.9%) subjects. The mean length of stay of delayed subjects was 256 minutes. Group A 146 (61.4%) had more subjects than group B 92 (38.6%) (p < 0.001). Fifty eight (39.7%) patients stayed between 2-3hours in Group A vs. B 23 (25%) (OR 2, 95% CI 1.1-3.5). Common reason of delay in Group A was multiple consultations with further investigations 70 (48%) (p < 0.001) while file making process was common 40 (43.5%) in group B (p < 0.001).
  
  
  CONCLUSIONS
  Out of admitted patients 67% were delayed mainly due to late advised admission with major reason of delay were multiple consultations.
authors.affiliation: Al-Noor Specialist Hospital, Makkah, Kingdom of Saudi Arabia.
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Tashkandy
authors.forename: Zohair Jamil
authors.initials: ZJ
authors.lastname: Gazzaz
authors.forename: Mian Usman
authors.initials: MU
authors.lastname: Farooq
authors.forename: Khalid O
authors.initials: KO
authors.lastname: Dhafar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012529:Saudi Arabia; D013997:Time Factors; D055815:Young Adult