This cross-sectional study at Jimma University Medical Center (Ethiopia) assessed ED boarding time and associated factors in 422 adult patients admitted to the ED between May 1 and June 30, 2024, using patient interviews, chart reviews, and linear regression analysis.
Mean ED boarding time was 37.9 ± 30.0 h; 72.7% of patients had prolonged boarding (>6 h). Self-pay (+0.300 h), orange triage (+0.367 h), yellow triage (+0.706 h), comatose status (+0.654 h), and longer ED length of stay all increased boarding time. ICU admission (−1.118 h) and higher patient satisfaction were associated with shorter boarding time.
- Consecutive sampling may introduce selection bias, even though data were collected around the clock including weekends. - Single-center study at a major referral hospital in southwest Ethiopia, limiting generalizability. - No prior Ethiopian ED boarding data exist for comparison, and the 50% proportion assumption for sample size calculation may not reflect true prevalence.
In this resource-limited Ethiopian ED, nearly 3 in 4 admitted patients waited far longer than the 6-hour benchmark — driven by self-pay status, intermediate triage acuity, and comatose presentation. Hospitals in similar settings should prioritize computerized bed management, dedicated bed managers, expanded insurance coverage, and streamlined interdepartmental transfer protocols to cut boarding time.
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