• Md Anisur Rahman, Bridget Honan, Thomas Glanville, Peter Hough, and Katie Walker.
• Murrumbidgee Local Health District, Wagga Wagga, New South Wales, Australia.
• Emerg Med Australas. 2020 Jun 1; 32 (3): 416-421.

ObjectivesHealth services have an imperative to reduce prolonged patient length of stay (LOS) in ED. Our objective is to develop and validate an accurate prediction model for patient LOS in ED greater than 4 hours using a data mining technique.MethodsData were collected from a regional Australian public hospital for all ED presentations between 1 January 2016 and 31 December 2017. A decision tree algorithm was built to predict patients with an ED LOS >4 hours. A total of 33 attributes were analysed. The performance of the final model was internally validated. Clinically relevant patterns from the model were analysed.ResultsThe accuracy of the model was 85%. We identified that patients at our site who were at high risk of ED LOS >4 hours were those who were waiting in ED for a medical consultation, or those who were waiting for a urology, surgical, orthopaedic or paediatric consultation if the request for consultation occurred more than 2 hours after the patient was first seen by an ED doctor.ConclusionThis model performed very well in predicting ED LOS >4 hours for each individual patient and demonstrated a number of clinically relevant patterns. Identifying patterns that influence ED LOS is important for health managers in order to develop and implement interventions targeted at those clinical scenarios. Future work should look at the utility of displaying individual patient risk of ED LOS >4 hours using this model in real-time at the point-of-care.© 2019 Australasian College for Emergency Medicine.

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