1. DETERMINANTS TO LONG HOSPITAL STAY OF
PATIENTS IN THE MEDICAL WARDS AT EMBU LEVEL 5
HOSPITAL, EMBU COUNTY, KENYA.
DEBRA KATHURE
HB1/40743/19.
2. ABSTRACT
• Study aims to investigate factors contributing to
long hospital stay of patients in medical wards at
Embu level 5 Hospital.
• Specific objectives involved investigating Patient-
related factors, health care provider related factors
and hospital related factors.
• This was a cross- sectional descriptive study,
purposive sampling technique was used and to get
the sample size Fischers formula was applied to get
number of respondents which was 58.
3. Abstract cont.
• Data was collected using a structured questionnaire
filled by the 58 respondents.
• Data analysis was done and results indicated key
factors including age,gender, cormobidities,lack of
social support, severe illnesses, poor quality of
care, inadequate communication and coordination
among health care providers, inadequate hospital
infrastructure and inefficient hospital policies and
protocols.
4. Abstract cont.
• Results of this study informed interventions aimed
at reducing the length of hospital stay,improving
patients outcomes and reducing healthcare costs.
• Recommendations include ensuring consistent and
meaningful patient centered care delivery,
revisiting policies and protocols in the hospital,
national government to promote awareness and
utilization of medical insurance cover.
5. INTRODUCTION
• In recent years ,long hospital stay in medical wards
has been a critical challenge faced by health care
systems worldwide.
• Globally,an estimate of 5-15% and nationally 20%
patients are enduring longer than necessary
hospitalization.
• This issue has been associated with hospital
acquired infections the second most prevalent
cause of death globally approximately 1.7 million
affected causing 90000-99000 deaths annually
according to the World Health Organization (WHO).
6. OBJECTIVES
• To investigate patient related factors contributing
to long hospital stay of patients in the medical
wards at Embu level 5 Hospital.
• To investigate health care providers related factors
contributing to long hospital stay of patients in
medical wards at Embu level 5 Hospital
• To investigate hospital related factors contributing
to long hospital stay of patients in the medical
wards at Embu level 5 Hospital.
7. LITERATURE REVIEW
Patient related factors
-Study in Nigeria Lagos University Teaching Hospital,
found advanced age was associated with Long
hospital stay(Enyuma et Al,2019).
-Female gender has been associated with Long
hospital stay (Roger, Debuyzer et Al,2019).
-Cormobidities has been identified contributing to
long hospital stay at St.Thomas Hospital in United
Kingdom (Gidman et Al,2019).
-Lack of social support was found to impact length of
hospital stay in study conducted at Kenyatta National
8. Literature review cont.
Healthcare provider related factors
-Study at St.Marys Hospital identified inadequate
staffing levels led to longer hospital stay (Cass
&Charlton,2022).
-Research done at Agha Khan University Hospital
found poor communication among health care
providers as a factor contributing to long hospital
stay (Kariuki et Al, 2021).
-Poor quality of care lead to longer hospital stay
(Gao,Liu et Al ,2022).
9. Literature review cont.
Hospital related factors
-Study at Lagos University Teaching Hospital found
that inadequate hospital facilities contributed to long
hospital stay (Achi,Ayobami et Al,2021).
-Study at Agha Khan University Hospital found that
inadequate hospital policies and protocols for
discharge planning one of the contributors to long
hospital stay(Otieno et Al,2022).
10. RESEARCH METHODOLOGY
• This was a descriptive cross - sectional study.
• Study area was Embu level 5 Hospital, Embu
county, Kenya.
• Purposive sampling technique was used and
sample size determined by use of Fischer's formula
which generated total of 58 respondents.
• Data collection was done by use of a structured
questionnaire composed of four parts:
demographic characteristics, patient related
factors, healthcare provider related factors and
hospital related factors.
11. Research methodology cont.
• Data analysis involved use of statistical methods to
examine relationship between the independent
and dependent variables.
• Descriptive statistics such as means, frequencies
and percentages were used to summarize data.
• Clearance to conduct study was obtained from
Chuka University Nursing Department and
management of Embu level 5 Hospital.
• Participants included only individuals who
voluntarily signed consent form.
12. RESULTS
Patient related factors
Majority 41.38% aged above 60years in agreement
with previous studies advanced age was associated
with Long hospital stay.65.52%were female and
34.48% male identifying female gender as key
factor.Majority 56.9% studied only up to primary
level scarcely explored in previous studies posing
level of knowledge as a factor.51.73% unemployed
questioning socioeconomic status as a factor.55.17%
diagnosed with cardiovascular conditions,72.14%
had cormobidities,48.28% reported lack of social
support and 58.62% had no health insurance cover.
13. Results cont.
Healthcare providers related factor
According to 55.17% of respondents, healthcare
providers were hardly available and accessible for
treatment in wards.58.62% respondents reported
healthcare providers were not adequate to provide
proper treatment and care in the wards.51.72%
reported poor communication between healthcare
providers
Majority of 48.28% indicated they never received
patient centered care,25.86% reported only
sometimes and 17.24% always received patient
centered care.
14. Results cont.
Hospital related factors
Majority 51.72% indicated that medical equipment
were inadequate to meet their medical needs in
agreement with previous studies.
55.17% reported delay in receiving medical care such
as receiving diagnostic test results.
67.24% reported experiencing delayed medical care
and discharge due to hospital policies and protocols.
15. RECOMMENDATIONS
• County and national government in association
with hospital create policies that promote
awareness and utilization of medical insurance
cover.
• Policymakers to consider revisiting policies and
protocols contributing to delays and hinder patient
experiences and timely care.
• Hospital to adopt strategies to ensure consistent
and meaningful Patient centered care delivery.
• Hospital administration and county government to
ensure there is enough staff and medical
equipments to provide medical care services.
16. REFERENCES
• Cass, A. R., & Charlton, K. E. (2022). Journal of
Human Nutrition and Dietetics, 35(6), 1043-1058.
• Gao, Q., Liu, M., Peng, L., Zhang, Y., Shi, Y., Teuwen,
D. E., & Yi, H. (2022).
• Otieno, P. A., Campbell, S., Maley, S., Obinju
Arunga, T., & Otieno Okumu, M. (2022).
