Hospital Length of Stay and Related Factors for COVID-19 Inpatients Among the Four Southern Regions Under the Proposed Southern Business Unit of Saudi Arabia

Abstract

Objective

To assess the length of stay (LoS) variation for COVID-19 inpatients among the four regions of the Southern Business Unit (SBU).

Methods

This is a comparative retrospective study of the LoS of COVID-19 inpatients in the four regions of the SBU in the KSA. Data was collected from the Ministry of Health (MoH) in all hospitals in the SBU. Participants were all patients admitted with confirmed COVID-19 between March 2020 and February 2021. Variables included region (variable of interest), demographics, comorbidities, and complications. Multilinear regression was performed to control for any factors that might have had an association with LoS.

Results

The mean LoS of the total sample was 10 days and Bisha (the reference) was 7 days. Compared to Bisha, LoS in Jazan was 34% longer, in Najran 62% longer, and Aseer 40% longer. We observed that other factors also had an association with LoS, compared to Bisha, compared to the references, Saudi patients had a 15% shorter stay; admission to ICU increased LoS by 57%; patients who died during hospitalization had a 39% shorter LoS; the complications from COVID-19 of acute kidney injury and ARDS increased LoS by 22% and 48% respectively.

Conclusion

After statistically controlling for confounders, this study reveals that LoS was significantly impacted by region in the SBU in the KSA. We recommend that further study be conducted to illuminate the underlying causes of this variation which may be organizational or structural to ensure high quality of care, access to care, and equity of resources throughout all regions of the SBU in accordance with the new Model of Care in Vision 2030.

Keywords:

• COVID-19
• length of stay
• Southern Business Unit
• Health Holding Company
• KSA

Abbreviations

LoS, length of stay; SBU, Southern Business Unit; KSA, Kingdom of Saudi Arabia; ICU, intensive care unit; CI, confidence interval; OR, odds ratio; HTN, hypertension; ARDS, acute respiratory distress syndrome; MoH, Ministry of Health; GIT, gastrointestinal tract.

Ethical Approval

Institutional Review Board Statement: Hospitals who reported the data to the MOH obtained, and the Clinical Excellence General Directorate of the MOH owned the data provided based on ethical approval from The Central Institutional Review Board of the MOH for providing the ethics review number IRB- log No: 20-163E. Informed Consent Statement: Data were taken from the Clinical Excellence General Directorate of the MOH Data Availability Statement: The data presented in this study are available on request from the corresponding author. Data were maintained in accordance with the Declaration of Helsinki.

Acknowledgments

The authors are grateful to the following for making this study possible. The King Abdulaziz City for Science and Technology (KACST) for supporting. The Clinical Excellence General Directorate of the MoH for making the data available. The Central Institutional Review Board and the General Administration for Research and Studies for providing the ethics review.

Disclosure

The authors declare that they have no competing interests.

Additional information

Funding

This study did not receive any specific grant from funding agencies in the public, Profit, or not-for-profit sectors.