Waiting time and 48-hour outcome amongst patients with medical emergencies at the accident & emergency unit of Mulago hospital.

Abstract

Background: The time patients have to wait from the moment they arrive at a health facility to the time they see a doctor has a critical impact on morbidity and mortality especially for patients with medical emergencies. Objectives: To determine the patient waiting time from arrival to medical management, the 48-hour outcome and the association between waiting time and 48- hour outcome amongst patients presenting with medical emergencies at Mulago Hospital Accident and Emergency unit (A&E unit). Methodology: This was a prospective cohort study conducted between August and October 2015 in the A&E unit of Mulago Hospital in Kampala, Uganda. 305 patients with medical emergencies were followed through the medical side of the A&E unit, with the study team recording their time of arrival, time seen by a doctor and time treatment was given; their final outcome in terms of admission status and mortality were also noted. Data Analysis: Descriptive statistics were summarized using medians and interquartile ranges; this was followed by univariate analysis and then multivariate analysis for selected variables. All data analysis was done using STATA®. Results: The median waiting time was 68 min (IQR: 22-140) with a 48-hour mortality of 8.9% (27/305). Waiting time was longest in the most acutely ill triage category (Red) at 91.5 min (IQR 20-139). Muslim patients had a shorter waiting time than other religions (56 min, IQR 12-123). There was no association between delay and mortality. Conclusion: Waiting times in Mulago Hospital are long across all triage categories but longest for the most critically ill patients.