LENGTH OF STAY AMONG EMERGENCY DEPARTMENT PATIENTS AT A PRIVATE TERTIARY HOSPITAL IN SOUTHWESTERN NIGERIA: A 5-YEAR INSTITUTIONAL RETROSPECTIVE STUDY

Abstract

Abstract: Background: Length of Stay (LOS) is a key performance indicator in emergency department (ED), reflecting both efficiency and quality of care. While extensively studied in high-income countries, there is limited evidence from sub-Saharan Africa, particularly from Nigerian private teaching hospitals. This study assessed LOS and demographic patterns among ED patients at Afe Babalola University Multisystem Hospital (AMSH) over a five-year period.

Method: We conducted a retrospective cross-sectional review of all adult ED visits between January 2020 and December 2024. Data were extracted from electronic medical records for 3,730 eligible cases. Variables included age, sex, year of presentation, and LOS (categorized as 1, 2, 3, 4, or ≥5 days). Descriptive statistics summarized patient characteristics, while chi-square tests assessed associations, with significance set at p<0.05.

Results: Males accounted for 53.4% of patients, and younger adults (≤45 years) represented 57.8% of cases. The proportion of young patients increased significantly from 48.2% in 2020 to 66.0% in 2024 (p<0.001). Most patients had short LOS: 26.0% stayed one day and 50.8% two days, while only 1.9% remained ≥5 days. LOS patterns shifted notably over time, with one-day stays declining (48.8% in 2020 to 27.4% in 2024) and two-day stays rising (32.2% to 50.1%; p<0.001). Annual ED volume more than doubled from 475 cases in 2020 to 1,000 in 2024.

Conclusion: AMSH’s ED is characterized by rising patient volumes, a predominance of younger adults, and relatively short LOS compared with public Nigerian hospitals. These findings suggest efficient patient flow supported by private-sector resources and structured management processes. However, excessively short stays may risk premature discharge, underscoring the need for prospective multi-center studies linking LOS with outcomes, satisfaction, and clinical diagnoses to guide emergency care policies in Nigeria.