Bridging women's emergency and primary healthcare: Factors associated with prolonged obstetrics and gynecology emergency room stay in a Saudi university hospital

Abstract

Objective: Length of stay (LoS) is a significant performance indicator in healthcare systems. Prolonged LoS in the obstetrics and gynecology emergency rooms (OB-GYN ERs) contributes to ER congestion and resource inefficiencies. The aim of this epidemiological study was to identify factors associated with prolonged LoS among patients attending a university hospital OB-GYN ER in Saudi Arabia. Methods: A retrospective analysis was conducted on 7987 OB-GYN ER visits from January to December 2022. Variables analyzed included patient age, triage level, visit timing and season, discharge status, and chief complaint. Predictors of prolonged LoS were assessed using a multivariable linear regression analysis. Results: Prolonged LoS was observed in 19.62% of visits. Higher-acuity triage levels were associated with shorter LoS. Patients who were admitted or referred had shorter LoS than those discharged routinely, while absconded patients and those not located had significantly longer stays. Visits for non-obstetric complaints such as cardiovascular or neurologic issues were associated with longer LoS than obstetric-related complaints. Seasonal and temporal factors were also significant, with shorter durations noted in summer and nighttime visits. Conclusion: Multiple factors contribute to variation in LoS in OB-GYN ER settings, including triage severity, time of visit, and type of complaint. Strengthening the integration of women's health subspecialties within family medicine at the primary healthcare level can play a pivotal role in managing non-urgent cases more efficiently. These improvements align with the goals of Saudi Vision 2030 by enhancing healthcare delivery, optimizing resource utilization, and expanding access to specialized women's health services outside hospital-based OB-GYN ER settings.