An-Najah National University 

 

Faculty of Graduate Studies 
 

 

 

 

 

 

 

FACTORS ASSOCIATED WITH INPATIENTS’ 

DISCHARGE TIME: PRIVATE HOSPITAL 

BASED- STUDY AT NABLUS GOVERNORATE 
 

 

 

 

 

 

 

By 

Ahmed Abd-Alrahman Hamdi Saify 

 

 

 

 

Supervisor 

Dr. Abdualsalam Alkhayyat 

 

 

 
This Thesis is Submitted in Partial Fulfillment of the Requirements for the 

Degree of Master of Public Health Management, Faculty of Graduate 

Studies, An-Najah National University, Nablus - Palestine. 

2024 



ii 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FACTORS ASSOCIATED WITH INPATIENTS’ 

DISCHARGE TIME: PRIVATE HOSPITAL 

BASED- STUDY AT NABLUS GOVERNORATE 
 

By 

Ahmed Abd-Alrahman Hamdi Saify 
 

 

This Thesis was defended successfully on 13/10/2024 and approved by: 
 

 



iii 

Detection  

الحمد هلل على تمام نعمته وان قد من علي بان اتم هذه الرسالة بعد جهد ومثابرة و صعوبات 

 رب العالمين وطموحات…. فالحمد هلل 

 إلى معلم البشرية ونورها سيدنا محمد عليه أفضل السالم والتسليم

 الى والدي ووالدتي اللذين زيناني بتاج العلم اطال هللا عمركما وأحسن عملكما

 الى سكن الحياة وعوني في مسيرتي زوجتي الغالية 

 الى بذرة الفؤاد وامل الغد ابنائي حفظهم هللا عبد الرحمن، مريم

 الى اخوتي واخواني مصدر ثقتي واعتزازي 

 واالسرى البواسل والجرحى الميامين الى الشهداء االبرار …

 الى كل هؤالء اهدي هذه الدراسة وآمل من هللا ان تكون فاتحة خير وعلم وان ينفعنا وينفع بنا 

 اخوكم، احمد الصيفي 

 

 

  



iv 

Acknowledgements 

I am deeply grateful for the guidance and support that illuminated my path throughout 

this research endeavor. This paper stands as a testament to the collective effort and 

encouragement of cherished family and friends, whose unwavering support propelled us 

forward. 

First and foremost, my heartfelt appreciation goes to Dr. Abdulsalam Alkaiat invaluable 

mentorship and meticulous feedback significantly shaped this paper's content, structure, 

and direction. 

We sincerely thank the esteemed faculty members and advisors at AL-Najah University 

who contributed their expertise and insights to enrich our thesis. 

Lastly, I extend my gratitude to all who lent their support and encouragement, 

contributing to the completion of this thesis. 

 

  



v 

Declaration 

I, the undersigned, declare that I submitted the thesis entitled: 

FACTORS ASSOCIATED WITH INPATIENTS’ 

DISCHARGE TIME: PRIVATE HOSPITAL 

BASED- STUDY AT NABLUS GOVERNORATE 
 

I declare that the work provided in this thesis, unless otherwise referenced, is the 

researcher’s own work, and has not been submitted elsewhere for any other degree or 

qualification. 

Student's Name Ahmed Abd-Alrahman Hamdi Saify 

Signature:  

Date: 13/10/2024 

 

  



vi 

Tables of Contents 

 

Detection ......................................................................................................................... iii 

Acknowledgements ....................................................................................................... iv 

Tables of Contents ........................................................................................................... vi 

List of Tables ................................................................................................................. viii 

List of Appendices ........................................................................................................... ix 

Abstract ............................................................................................................................. x 

Chapter One: Introduction and Literature Review ........................................................... 1 

1.1 Introduction ................................................................................................................. 1 

1.2 Significance of the study ............................................................................................. 7 

1.3 Aim of the Study ......................................................................................................... 8 

1.4 Research objectives ..................................................................................................... 8 

1.5 Research Question ...................................................................................................... 8 

1.6 Literature review ....................................................................................................... 10 

1.7 Admission and discharge time .................................................................................. 21 

1.8 The Impact of Insurance on Patient Discharge Time from Hospitals ....................... 26 

Chapter Two: Methodology ............................................................................................ 31 

2.1 Introduction ............................................................................................................... 31 

2.2 Study design .............................................................................................................. 31 

2.3 Data Sources ............................................................................................................. 31 

2.4 Sample Size ............................................................................................................... 31 

2.5 Study Population ....................................................................................................... 32 

2.6 Data collection tool ................................................................................................... 33 

2.7 Validity and Reliability ............................................................................................. 35 

2.8 Statistical analysis: .................................................................................................... 35 

Chapter Three: Results .................................................................................................... 36 

3.1 Results ....................................................................................................................... 36 

3.2 Study Hypothesis and the results .............................................................................. 38 

Chapter Four: Discussions, Conclusions and Recommendations ................................... 42 

4.1 Discussion ................................................................................................................. 42 

4.1.1 Gender and Discharge Time .................................................................................. 42 

4.1.2 Intersectionality and the Discharge Experience ..................................................... 43 

4.1.2 Patient-Related Factors Influencing Length of Stay .............................................. 45 

4.1.3 Impact of Care Quality on Patient Satisfaction and time discharge ...................... 46 



vii 

4.2 Conclusion ................................................................................................................ 48 

4.3 Recommendations ..................................................................................................... 49 

References ....................................................................................................................... 50 

Appendices ...................................................................................................................... 55 

 ب ............................................................................................................................... الملخص 

 

 

 

 

  



viii 

List of Tables 

 

Table 1: Demographic Characteristics of Patients ............................................................... 36 

Table 2: Distribution of Patients by Accommodation Type in a Hospital ........................ 37 

Table 3: Distribution of Patients by Patient's Condition in a Hospital .............................. 37 

Table 4: Distribution of Patient Length of Stay in the Hospital ......................................... 37 

Table 5: Occurrence of Complications in Patients ............................................................... 38 

Table 6: L inear regression between Age (in years) and Length of stay in the hospital (in 

days) ................................................................................................................................. 38 

Table 7: L inear regression between patient's condition and Length of stay in the hospital 

(in days) ........................................................................................................................... 39 

Table 8: Linear regression between occurrence of complications and length of stay in the 

hospital............................................................................................................................. 39 

Table 9: Linear regression between type of care and length of stay in the hospital ........ 40 

Table 10: Linear Regression Analysis of Variables Impacting Length of Stay in the 

Hospital ............................................................................................................................ 40 

 

 

 

 

 

  



ix 

List of Appendices 

 

Appendix A: IRB Approval Letter ................................................................................. 55 

 

 

  



x 

FACTORS ASSOCIATED WITH INPATIENTS’ 

DISCHARGE TIME: PRIVATE HOSPITAL  

BASED- STUDY AT NABLUS GOVERNORATE 
 

By 

Ahmed Abd-Alrahman Hamdi Saify  

Supervisor 

Dr. Abdualsalam Alkhayyat 

Abstract 

This work explores factors that affect the discharge time of patients from a private Nablus 

hospital, West Bank, State of Palestine. This study adopts a retrospective observational 

design with regression analysis and identifies age, patient condition, occurrence of 

complications, and type of care as key determinants for discharge times. 

Introduction and Background: The present research is undertaken to get an overview 

of the various factors that go with the discharge time of patients from a private hospital 

setup and contribute toward the better understanding of the process, ultimately leading to 

improved outcomes and enhanced patient satisfaction. 

Methodology: This was an observational retrospective study with existing quantitative 

data culled from the electronic health records, management, and financial databases of 

the hospital. Regression analysis was used to predict the relationships between patient 

characteristics and times of discharge. 

Results: There were significant factors that influenced the time for discharge of patients 

as obtained by regression analysis. Major findings are: age, B = 0.077, p<0.001; patient's 

condition, B = 2.417, p = 0.016; occurrence of complications, B = 11.649, p<0.001; and 

type of care, p<0.001, all having a significant effect on the length of stay in the hospital. 

Conclusion: Timing of discharge remains one of the most critical areas for discharge 

process optimization and enhancing patient satisfaction. In this regard, the improvement 

of communication, streamlining the trajectories of care, and rendering priority to patient-

centered care are recommended towards the attainment of these objectives. 

Keywords: Factors associated; discharge time; private hospital; Nablus governorate. 

 



 

1 

Chapter One 

Introduction and Literature Review  

1.1 Introduction  

The patient's discharge time, among other things, bears a very significant influence on the 

modern healthcare delivery framework, including the general efficacy in the hospital 

operations and patient satisfaction. The dynamics of the patient discharge process are 

multiple and complex. An exploration of these determinants in the context of Nablus, 

West Bank, Palestine, would turn out to be of great importance for improving the quality 

of healthcare provision. The research focuses on the private hospital of Nablus as a means 

of contributing to the current enormous literature and research base on determinants of 

the time taken in discharging patients. 

The time a patient leaves the hospital is a significant part of healthcare operation that, 

beyond the immediate concern of individual patient experience, plays a more important 

role. The effectiveness in the discharge process itself bears great importance with respect 

to the general working operation of the hospital: in this sense, this process affects resource 

distribution, staff workflow, and overall operational efficiency within the hospital.  

Discharging patients late may hurt not just the discharged individuals but also the 

operation of the hospital, which is left open and, in its turn, closes the doors to new 

incoming patients, worsening problems associated with bed management. Accordingly, 

it is very important to look deeply into the various factors that affect discharge times, to 

maximize not only patient satisfaction but also to optimize hospital resources and make 

healthcare delivery smoother. 

This analysis is of paramount importance, more so in the context of Nablus, West Bank, 

Palestine, where the healthcare profiles rapidly undergo changes. This complicates the 

process of discharge, and the interplay of cultural, socio-economic, and geopolitical 

factors in the region shows distinctive challenges. Important in this endeavor is a true 

understanding of these nuances; hence, the development and tailoring of interventions 

that will speak to local context, ensure direct applicability, and find relevance in the 

specific healthcare landscape of Nablus. This paper is, therefore, an attempt to home in 

on a private hospital in this region, whereby insights created can be utilized by health 



 

2 

professionals, health administrators, and also health policymakers as benchmarks in 

bettering the existing practices, hence contributing to a health ecosystem that will be 

bettered in improving health care in Nablus, West Bank, Palestine. 

This paper appears to build itself in light of the experiences of patients and the satisfaction 

with hospitals in the Palestinian healthcare context. Al Sharif (2008) conducted a PhD 

dissertation on patient satisfaction with the services from the district of Nablus Hospitals, 

providing an aspect of the subtlety of experiences in receiving healthcare in the region. 

By extension, Takruri, Radwan, El Jabari, Nawajah, & Hassan (2023) had a mixed 

method which would be illustrative of the kind of experiences that Palestinian patients 

have had with hospital services. Those two studies contributed rich qualitative 

perspectives on an in-depth exploration of the patient discharge process. 

At the same time, the foundational literature on patient satisfaction and hospital 

experiences vis-à-vis the Palestinian healthcare setting is a bedrock for this research 

endeavour. For instance, in the doctoral dissertation study by Al Sharif (2008), the scope 

of patient satisfaction of hospital services in the Nablus district deepens the reader's 

understanding of healthcare experiences in the region. By being this detailed toward 

understanding patient satisfaction, Al Sharif's work creates the foundation needed to 

understand the larger healthcare environment and also provides a contextual setting for 

the current analysis of the specific issue: discharge times. 

In the vein of Al Sharif (2008); Takruri, Radwan, El Jabari, Nawajah, & Hassan (2023) 

offer a powerful mixed-methods study that explores the full depth of experience of 

Palestinian patients with hospital services. This study goes beyond mere metrics on 

satisfaction and captures the qualitative essence of patient interaction with health systems. 

By taking a mixed-method approach, the work of Takruri, Radwan, El Jabari, Nawajah, 

& Hassan (2023) not only describes measurement through numbers but also reveals the 

qualitative nuances defining the patient-provider relationship. Added together, these 

studies represent a great contribution to the literature since they provide important 

qualitative perspectives, the bedrock from which a more nuanced and well-rounded view 

of the patient discharge processes in Nablus, West Bank, Palestine can be gleaned. 

  



 

3 

Thus, a more comprehensive understanding of the general context for the entire health 

system has been crafted through the amalgamation of insights born from this wide and 

deep exploration of patient satisfaction by Al Sharif (2008) and the in-depth mixed-

method study by (Takruri, Radwan, El Jabari, Nawajah, & Hassan, 2023). It is knowledge 

crucial in the generation and illumination of the contexts that affect the perceptions of 

patient discharge dynamics—as a phenomenon—beyond the phenomenon itself, not as 

just another event but as an integral part of the overall journey of the patient within the 

Palestinian healthcare system. 

Medical conditions are another paramount factor in the process of discharging patients. 

This is reflected upon in Sawalha's paper on the description of the discharge process, 

where the patients with ischaemic stroke are concerned, in Palestine (2009). "It is 

therefore intuitive that the burden imposed by the severity and complexity of medical 

conditions will also be an important determinant of length of stay, and the time required 

for discharging the patient", says Qadah (2014) in her study on medication beliefs and 

adherence in Nablus statin users. 

The example available from the characterization of hospitalized ischemic stroke patients 

in Palestine by Sawalha (2009) underlines that the relationship between medical 

conditions and the patient discharge process is complicated. The latter work gives insight 

into specific medical conditions that become influential in the process of hospital stays 

and, therefore, gives one the opportunity to understand the more subtle aspects of the 

treatment process for patients with a diagnosis of ischemic stroke. These medical 

conditions are highly determinant of the period over which these patients are supposed to 

be kept in the hospital and hence, determine the period within which these patients will 

be discharged from the hospital. Research by Sawalha, through an illustration of the 

medical details and complexities for ischemic stroke patients, helps outline how different 

health conditions influence the overall patient experience. The study brings to light 

implications on the length of stay and the potential for discharge. 

Besides the factor that relates to medical conditions, Qadah (2014) dissertation on 

medication beliefs and adherence among statin users in Nablus brings out the issue of 

multifaceted determinants of what impacts recovery and discharge for patients. Therefore, 

in the context of the area of focus by Qadah, the issue is based on examining the complex 



 

4 

interaction of medication-related factors, explaining patients' beliefs and adherence to 

prescribed medication. This dimension of patient care forms an integral part of the 

recovery process, and directly affects the period considered appropriate for patient 

discharge. As such, medication-related factors would be important to understand further 

and optimize the patient discharge process in the context of Nablus, West Bank, and 

Palestine. 

Together, Sawalha's insights into the medical intricacies of the ischaemic stroke patient 

and Qadah's presentation of beliefs and practices in regard to medications shine light on 

complementary possibilities that may work jointly in the larger puzzle of patient 

discharge. This again highlights that the medical situation of the patient is linked up with 

the adherence of the patient to the prescribed medications; both are tangled factors that 

need exhaustive investigations in order to work on and improve overall effectiveness and 

efficiency of the process of patient discharge from hospitals in the Nablus healthcare 

setting. 

In addition, Abdo's (2008) research into factors affecting pain intensity in post-caesarean 

section may be applicable to supporting the relevance of patient comfort and well-being, 

since the variable may have an impact on the discharge-readiness status of the patient. As 

indicative from the literature reviewed above, patient experience and health service 

delivery are interesting areas of research, as their interaction with medical aspects calls 

for an all-inclusive study of patient discharge times in a private hospital. 

In this way, Abdo (2008) study prescribes a very important angle to a means in which to 

analyze the times of patient discharge; the prescience of this dimension under 

consideration is an all important step in determining adequacy within the study and 

reporting a coherent and non-bias inference process. The results have established that 

determinants of when a patient is discharged must transcend purely medical 

considerations and take into account pain management and the overall experience of a 

patient. Patient care attributes, which would indicate the satisfaction and well-being of a 

patient, hence become the prime issues to represent the dynamism associated with the 

patient discharge process from a private hospital. 

  



 

5 

In concert with other studies that explore medical conditions, medication adherence, and 

patient satisfaction, Abdo (2008) investigation adds more depth to the understanding of 

the interplay between medical factors and the patient experience in health care. 

Collectively, these studies lay a platform for the comprehensive study of patient discharge 

times, recognizing the multifaceted discharge process within the nuanced health care 

environment of Nablus, West Bank, Palestine. 

In the general context of research into satisfaction, the works of (Hargraves, Wilson, & 

Zaslavsky, 2001); (Young, Meterko, & Desai, 2000) provide methodological knowledge 

on how exactly to adjust for patient characteristics when one analyses the reports about 

having hospital care. These references will help the study to guide the inclusion of the 

patient satisfaction aspect in determining the times of patient discharge at the private 

hospital in Nablus. 

Among the causes being discharge processes, patient satisfaction is one of the most 

important factors that reflect the success of the general functionality. A broad study by 

Al Sharif (2008) in regard to patient satisfaction in Nablus underlines the capturing of the 

essence from patient experiences in health facilities. By investigating the quality of 

interactions between patients and health care providers, Al Sharif's results indicate that 

discharge efficiency relates directly to the perceptions that patients hold about their care. 

The paper contributes to the core insights into the wider perspective of patient 

satisfaction, underlining the process of discharge from Palestinian hospitals not only as a 

logistical priority but also as an area important for the patient's overall journey of health 

care. The findings of Al Sharif's research are therefore very valuable for private hospitals 

that wish to enhance their discharge protocols in creating a better healthcare experience 

for patients in Nablus. 

Appropriately identified, patient discharge timing is among the major aspects that 

determine the flow of operations in healthcare-as established in the mixed-methods study 

on Palestinian healthcare experiences by Takruri et al. (2023). This places in perspective 

the necessary holistic understanding of the relationship between the patient and the 

provider if any effort is to be made toward reducing delays in discharge. Takruri et al. 

show that some qualitative nuances, such as the emotional experience of patients and their 

perceived level of empathy from healthcare providers, are just as crucial in shaping the 



 

6 

satisfaction of patients as quantitative metrics. This is a complementary study to Al 

Sharif's quantitative approach, developing nuanced interpersonal aspects of health care 

that support the argument for the implementation of a patient-centered approach in 

discharge strategies focused on timely, empathetic, and effective communication. These 

are very crucial strategies in reducing delays in discharges and easing bed management 

problems affecting the hospital's capability to efficiently admit new patients. 

Added to the complexity of understanding discharge processes, especially for chronic 

conditions that require extended care, is Sawalha's 2009 research on patients with 

ischemic stroke. In Sawalha's analysis on how a stroke impacts readiness at discharge are 

underlying factors showing just how significant a patient's medical condition is in 

determining discharge timing. For patients with a stroke, their medical condition typically 

will necessitate longer hospital stays in order to ensure stability at discharge. This need 

further complicates the process of discharge planning for patients with severe medical 

conditions. Sawalha's work continues to establish a basis on which discharge processes 

need to be individualized based on various patients' medical requirements, especially for 

those suffering from life-long conditions. In private hospitals, where there is greater 

flexibility in resource utilization, such understanding of the specific patient requirements 

may lead to better discharge practices consistent with the overall efficient running of the 

hospital. 

Qadah's dissertation (2014) on the medication beliefs and adherence of statin users in 

Nablus has strongly emphasized the unique aspect of the discharge process, in particular 

how patients' beliefs and behaviors about medication adherence can affect their readiness 

for discharge. It is also indicated that those who adhered strictly to the prescribed 

medicines were very likely to undergo smoother recovery processes, which in turn lead 

to shorter hospital stays. On the other hand, those patients with lower levels of adherence 

may have to stay longer due to complications, slower recoveries, or even because they 

will have to be further monitored. This is where this study comes into play: the patient's 

education and his adherence are two far-reaching factors that could ease discharge timing. 

In this respect, for Nablus, where sociocultural beliefs might affect patients' 

understanding of their medication, Qadah identifies that health providers should take 

these types of beliefs into account and respond to them during the discharge planning 

phase so that the actual discharge process is more competent in a cultural sense. 



 

7 

Lastly, Abdo's study regarding the intensity of pain after cesarean section, which is one 

method of surgical delivery, centers on the idea that readiness for discharge actually 

depends on the comfort of a patient, in which post-operative pain can make all the 

difference in discharge timing. Emphasizing pain as a determinant, Abdo's work simply 

goes to point out that effective pain management protocols form part of facilitating timely 

discharges for patients. Effective pain management is not only a comfort issue but also 

one factor that can affect a patient's physical and psychological readiness for discharge. 

This might have wider implications for reducing lengths of stay in hospitals such as 

Nablus, where resources may be limited, and thus accelerate the process of discharge. 

This approach will not only optimize bed use but also increase patient satisfaction in that 

the patient will not have to endure long periods of discomfort after discharge. The insights 

from Abdo's research make for a strong rationale for prioritizing comfort for the patient 

in discharge protocols, since it leads directly to efficiency in both hospital operations and 

patients. 

This research aims to contribute to the literature further and integrates qualitative insights 

with quantitative analyses in identifying and understanding influences on patient 

discharge times. In doing so, this research aspires to suggest recommendations for an 

optimized patient discharge process based on evidence and at the end to contribute to 

better healthcare quality in Nablus, West Bank, Palestine.  

1.2 Significance of the study 

Effective discharge of patients is one of the prime determinants in health care facilities 

that influences patients' satisfaction with care provided and the overall quality of 

healthcare services. In the case of Nablus, West Bank, Palestine, an underdeveloped 

region with growing needs of high-quality healthcare, there is a surprising dearth of wide-

ranging research on the factors that affect the length of stay in a private hospital. Whereas 

literature abound on patient satisfaction concerning services provided within hospitals, 

for example, Al Sharif (2008), and previous research on consciousness and the duration 

of stay by patients in hospitals, for example, by Takruri, Radwan, El Jabari, Nawajah, & 

Hassan (2023), there are little understandings on the quantitative factors influencing 

patients' discharge from health facilities on a time bound period. 

  



 

8 

Sawalha, 2009 has evaluated the medical condition of the inpatients in Palestine, and 

through the assistance of Qadah (2014) has conducted estimation of the medication 

compliance and its output; however, pathogenic and logistic problems in the medical, 

insurance-related, circumstances, how they operate alone and in collaboration to 

influence the time of discharge in this particular setting has not been extensively 

researched. In fact, such variables should be expounded and evaluated to foster quality 

health care among the private hospitals of Nablus. 

1.3 Aim of the Study 

To investigate and learn the causes of time of discharge among patients from private 

hospital in Nablus: medical conditions, insurance-related factors, and logistical issues; 

and to make recommendations about ways to maximize the patient discharge process in 

a hospital. 

1.4 Research objectives  

The objectives of this study are noted below: 

- To analyze and identify key determinants of patients' discharge timings from a 

private Hospital in Nablus. 

- The impact of the medical conditions, Insurance-related information, and Logistical 

matters on the Discharge Process. 

- Recommend ways for efficient discharge of patients from the patient hospital. 

1.5 Research Question 

Main Research Question: 

What are the key factors associated with patient discharge time in a private hospital in 

Nablus, West Bank, Palestine? 

Sub-Research Questions: 

- How does the severity of a patient's medical condition affect the time needed for 

discharge in the private hospital? 

- In what ways do delays in the insurance approval process impact patient discharge 

times? 



 

9 

- What is the relationship between bed occupancy rates and the length of time required 

to discharge patients? 

- How do logistical factors, such as staff availability and hospital resources, influence 

patient discharge timing? 

- What strategies can be implemented to improve the efficiency of the discharge 

process in the hospital? 

Main Hypothesis: 

Patient discharge time in such a private hospital in Nablus, West Bank, Palestine, was 

significantly associated with several factors, including medical condition, and insurance-

related factors. 

Null Hypothesis Main: 

The factors of medical conditions, insurance-related factors, and bed availability are 

insignificantly related to patient discharge times in a private hospital in Nablus, West 

Bank, Palestine. 

Sub-Hypothesis 1: 

The severity of a patient's case has a significant effect on the time needed for discharge 

in the private hospital. 

Sub-Hypothesis 2: 

Delays in insurance approval processes significantly impact patient discharge times in 

the private hospital. 

Sub-Hypothesis 3: 

There is a strong positive correlation between higher bed occupancy rates in the hospital 

and longer lengths of time required to discharge patients. 

Patient discharge timing is one of the important strategies in modern health care that 

affects hospital efficiency and patient satisfaction. This study concentrates on a private 

hospital in Nablus, West Bank, Palestine, to increase understanding about discharge 

processes and their determinants. Investigations into the factors that affect the timing of 

discharge are necessary since it impacts on hospital operations due to its effect on resource 



 

10 

management and patient throughput. 

These different local challenges on cultural variables, socio-economic, and geopolitical 

variables unique to Nablus complicate discharge dynamics. Earlier research, such as 

Sharif (2008) and Takruri, Radwan, El Jabari, Nawajah, & Hassan (2023), has been 

carried out to help define qualitatively the satisfaction of patients and hospital experiences 

at large as a foundation for understanding discharge issues. There is the contribution of 

medical conditions, especially ischemic stroke patients, cited by Sawalha (2009). Qadah 

(2014) on his part, espouses medication adherence in his 2014 work. Abdo (2008) 

research, focuses on post-caesarean pain and provides insight into the role of patient 

comfort in readiness for discharge. 

This paper considers a range of factors involved in the discharge process, including 

medical conditions, and medication adherence, to achieve better integration. In this sense, 

it will give implementable recommendations to improve discharge efficiency and health 

care quality in general for Nablus by mixing qualitative and quantitative analyses. 

1.6 Literature review 

Miles & Dansky (1997) add that the number of minutes passed in a waiting line and 

minutes spent being filled are directly proportional to a patient's satisfaction with 

ambulatory care. These are important determining factors in the establishment of any 

general approach to health service since as much as healthcare delivery is effective, 

dissatisfaction can sneak in the event of long waiting periods. Since the private voluntary 

hospital in Nablus community boasts of a satisfactory level of patient discharge and 

turnover, the hospital management should work towards improving such a level of 

performance. Used together with early assessment, efficient discharge processes 

contribute not only to the speedy exiting of patients but also to an overall positive 

perception of the healthcare journey. 

Effective discharge processes help to accomplish the goals of patient satisfaction and 

contribute to the optimization of resources in healthcare. In a private hospital in Nablus, 

resource allocation effectively has to be put in place to ensure prompt discharge and thus 

make bed turnover faster; this would ensure the utilization of available resources up to 

full capacity. It is not only better for the operation efficiency of a hospital, but is also 



 

11 

good for bringing positive impacts on patients in the sense of no unnecessary delays and 

efficient use of healthcare space. 

More substantially, the emphasis in the healthtime experience reaches further than the 

patients' welfare and into the health environment. The discharge procedures at the Nablus 

are involved in efficient service as an answerability to the said increased demographic 

demand hence improving the functionality of the hospital. For the private hospital to 

become quality and time reactive, the precepts raised here by Miles & Dansky (1997) 

have to be observed so as to become a patient-responsive, high-performing health 

environment. 

McDonald, Owings, & Jernigan (2006) postulated on Clostridium difficile infection after 

the discharge from a hospital, which brings out the possible infectious risk occurring soon 

when patients leave the short-stay hospitals. Such knowledge and mitigation of 

undertakings are vital in our case that necessitates the need to implement vibrant post-

infection preventive strategies in the private hospital in Nablus upon discharge. 

The study by McDonald, Owings, & Jernigan (2006)  of Clostridium difficile infection 

post hospital discharge, serves to focus on long-tail risks of infectious complications even 

during the patient's departure from the short-stay hospitals. This insight does elicit 

considerable thought in relation to the imperative of ensuring comprehensive post-

discharge infection prevention strategies in the specific context of a private hospital in 

Nablus. 

In a local environment where delivering health services in Nablus is a task that involves 

not just the quality level but even the safety aspect of the same, the research article of 

McDonald, Owings, & Jernigan (2006) presents concrete ways in setting up advance 

mechanisms to respond to and prepare for infectious risks beyond the present hospital 

experience, in ensuring the safety as well of the patients and the anticipated risks that they 

might encounter after discharge. 

  



 

12 

The present study also questions the necessity of careful healthcare provision in Nablus, 

West Bank, Palestine. In a region where diseases causing infection are a matter of 

paramount concern for a healthy living, the private hospital must focus on measures that 

go even beyond the mere staying period of a hospital. It includes reiterating on hygiene 

methods, reinforcing the step post-discharge surveillance, and collaborating in a 

sharpened manner with the healthcare community overall to reduce the risk of infectious 

complications (McDonald, Owings, & Jernigan, 2006). 

The insights provided by this study from McDonald, Owings, & Jernigan (2006) offer a 

very valuable reference point towards developing an infection prevention strategy tailored 

for the private hospital in Nablus that seeks to be at par with healthcare delivery 

worldwide. Such actions increase patient well-being and thereby create harmony with the 

larger objectives of increasing healthcare quality, safety, and resilience in dealing with 

the new challenges in healthcare. Indeed, gave a significant perspective of in-depth 

learning from the adverse events that affect patients after discharge from the hospital. 

This study is therefore going to provide the reference point for understanding and 

addressing the various factors contributing to the adverse events transition from hospital 

to home in this study carried out in a private hospital in Nablus (McDonald, Owings, & 

Jernigan, 2006).  

Indeed, Miles and Dansky 1997 show that an effective discharge process can go a long 

way in contributing to overall patient satisfaction. In the healthcare setting, patients in 

high-pressure environments such as private hospitals in urban areas have perceptions that 

are influenced mainly by the efficiency at which services are delivered. Delays in the 

discharge process may give a perception of inefficiency and erode trust in the healthcare 

facility. The private hospital in Nablus could continue enjoying its reputation in effective 

patients' care and reinforce patients' satisfaction by adopting strategies to reduce the 

waiting time and simplify the discharge process. Moreover, the compliance of the 

discharge practices with patients' expectations would enhance the quality of care and thus 

place the hospital in a leading position concerning patient-centered services in the area. 

Within this context, McDonald, Owings and Jernigan, (2006) emphasized that the 

significance of the effective discharge process is not confined to the issue of immediate 

patients' satisfaction but rather extends to the maximization of the available resources. 



 

13 

Effective discharge planning ensures rapid turnover of the hospital beds - something 

rather important in a private hospital where demand often exceeds capacity. Thus, by 

allocating the resources so efficiently, healthcare providers can manage more patients 

without compromising the quality of their care. McDonald et al. continue to highlight that 

resource management strategies utilized for discharge planning decrease waiting times 

for new patients and operational costs. For a private hospital in Nablus that balances high-

quality patient care with financial sustainability, it is of utmost importance that discharge 

processes are smooth and efficient, facilitating both operational efficiency and a superior 

patient experience. 

McDonald et al. (2006) further point out that another critical form of infection risk in 

patients is that associated with infection transmission upon discharge from hospitals, such 

as Clostridium difficile infection. This area of post-discharge care therefore underlines 

the importance of extending infection control measures to beyond the limits of hospital 

stay and making sure that patients are sent home with as little a chance of post-discharge 

complications as possible. It ensures better patient outcomes in the integration of infection 

prevention strategies into the discharge process and protection of public health in a private 

hospital in Nablus. Emphasizing infection control, even at discharge, reflects a 

commitment to patient safety in line with global best practices in healthcare. Some of 

these strategies may involve educating the patients about symptom-related infections, 

follow-up appointments, and resources to help them manage complications that may arise 

post-discharge. 

Miles and Dansky's study (1997) highlights the fact that a smooth discharge benefits not 

just the patient, but also the efficiency of the healthcare system. The ability to ensure 

timely discharges will enable hospitals to accommodate more patients, which is crucial 

in high-resource utilization settings such as private urban hospitals among Palestinians. 

Improvement in the discharge process will ensure that hospital beds are freed up to 

accommodate as many patients as possible to reduce queues and facilitate access to health 

services. This proactive approach towards patient turnover supports a model of seamless 

care in which patients can be smoothly transitioned from the hospital to the home 

environment with least disruption to the process of recovery. Efficient discharge planning, 

in this respect forms the bedrock of the attempt of hospitals to provide patient-centered 

care while optimizing operational efficiency. 



 

14 

McDonald, Owings, and Jernigan (2006) stress that adequate follow-up measures are 

necessary for minimizing infection risk following discharge. This could also be 

particularly relevant to patients who carry more substantial risks of infection, such as 

immunocompromised patients and surgical patients. Regarding this matter, a private 

hospital in Nablus has set their policy for after-discharge follow-through so the care for 

the patient doesn't cease outside the confines of the hospital but extends out into the post-

recovery phase. This approach shows an understanding of healthcare as part of a 

continuum, whereby post-discharge support and monitoring play an integrative part in the 

journey of full recovery of the patient. While doing so, this approach also depicts how the 

organization safeguards patient health while concurrently gaining trust with the patients 

and their families by showing dedication to long-term wellness and safety. Hence, the 

research team sets a very sound framework that could guide the formulation and 

implementation of policies on reducing adverse post-discharge events, improving patient 

outcomes, and increasing the standing of the facility. 

In Nablus's private hospital setting, it is paramount to understand the bigger picture of the 

complications that might arise post-discharge. As healthcare professionals consider 

ethical values and the elements noted by Forster, Bihari, Tiruvoipati, Bailey, & Pilcher 

(2020) they can formulate interventions and measures that are vital for reducing the risk 

associated with data management and patient safety threats. Therefore, this approach is 

fully in line with the generic purpose of optimization of patient discharge processes in 

order to ensure positive outcomes following hospital treatment. 

Next, the study evokes a question of re-evaluation for the strategies of discharge planning 

and embodiment in private hospital follow-up. Lessons from this research reassessing 

Forster, Bihari, Tiruvoipati, Bailey, & Pilcher (2020) can only bring about a whole new 

dimension in patient care implementation post-discharge through constant monitoring, 

patient education, and timely interventions in prevention as well as management of the 

many negative outcomes of therapy. That type of proactive stance will not only contribute 

to the assurance of enhanced safety but also foster excellence in the general quality 

delivery of healthcare services in Nablus (Kozak, Owings, & Hall, 2004).  

  



 

15 

The results of the study by Forster, Bihari, Tiruvoipati, Bailey, & Pilcher (2020) acquire 

importance in such dynamic health care and the development of evidence-based practices 

needed to meet patients' needs in Nablus. Ameliorating the causes of adverse events, the 

private hospital could get more engaged in offering good-quality, safe, and patient-

oriented provision of health care throughout the entire care delivery process. 

Kozak, Owings, & Hall (2004) National Hospital Discharge Survey provided a 

macroscopic perspective that enriched our overall view of discharge trends within the 

United States of America. Although such a wider view, beyond the base scope on a private 

hospital in Nablus, promotes context of the global healthcare situation in research that is 

connected to the study of patient discharge processes. 

This makes the importance of the national discharge trend be very relevant with the 

private hospitals of Nablus, where all of the health care providers involved in this 

topology strive to harmonize local practices with global trends. Understanding the 

development of the discharge process at a national level would ensure the chance to see 

local process strategies optimized in such a way that they meet the latest trends and best 

practice recommendations. 

Benchmarking an undertaking within the private hospital in Nablus will draw some health 

management based on the National Hospital Discharge Survey. The healthcare 

administrator will trace areas of strength and those in need of improvements quite easily 

by comparing the local practices and national trends. Such comparison allows for deep 

understanding of different dynamics involved in patient discharge so that the hospital 

aligns the strategies in place with those broader healthcare trends (Kozak, Owings, & 

Hall, 2004). 

It is against this background that the dynamism and integrated nature of the world of 

health care, in which innovation and good practice know no boundaries of geographic 

location, that the macroscopic insights provided by Kozak, Owings, & Hall, (2004) prove 

valuable and help provide a point of reference in sharpening the patient discharge process 

in Nablus. In only this way, it does it ensure that the private hospital, while catering to 

local needs, is also informed by global perspectives in improving the quality, efficiency, 

and patient-centeredness with which health care can be delivered in the region. 



 

16 

The "quicker-and-sicker" idea expounded by (Kosecoff, et al., 1990) and the need for 

postdischarge surveillance of SSI by the surgical patient, as suggested by Mitchell, Swift, 

& Gilbert (1999) demonstrate the impression of patients' states that sometimes last for a 

long time outside the hospital. Considering our study site of a private hospital in Nablus, 

where recognition of the possible consequence of the patients' medical conditions and the 

necessity for vigilant monitoring after discharge are important elements in understanding 

the discharge length of stay for patients, the following article mentions the notion of 

quicker-and-sicker patients. Such recognition in Nablus is particularly important because 

healthcare providers are usually faced with the determination of the orders of discharge, 

seeking to ensure that resources are utilized efficiently while care of high quality is given. 

Such a recognition process facilitates an informed discharge decision to ensure patients 

are declared fit for discharge not only on considerations of immediate recovery, but also 

the post-discharge complications that could come along (Mitchell, Swift, & Gilbert, 

1999).  

Mitchell, Swift, & Gilbert (1999) focus on having continuous surveillance of surgical 

wound infection, even beyond the hospital setup. By looking at this argument in relation 

to our study in Nablus, there is a great need to acknowledge that post discharge 

complications may affect the patient greatly in the form of surgical site infection. Being 

important for the patient in the private hospital, this calls for the need to acknowledge 

such potential complications and having surveillance mechanisms exercised by health 

care providers along the discharge process. This proactive approach supports the larger 

goals of ensuring patient safety and optimizing healthcare quality in this region (Mitchell, 

Swift, & Gilbert, 1999).  

Taken together, the above interpretation of the condition of the patient and the need for 

post-discharge monitoring, similarly described by (Kosecoff, et al., 1990); (Mitchell, 

Swift, & Gilbert, 1999) forms a more clear and in-depth explanation of factors that affect 

patients' discharge times from private hospitals in Nablus. It is thus an acknowledgment 

that the discharge process is made in line with the adherence to a patient-centered 

approach, which will ultimately result in positive results after being treated in hospitals. 

Parkes & Shepperd (2000) in a systematic review of Cochrane Database, the important 

role that effective discharge planning plays in enhancing positive post-hospitalization 



 

17 

outcomes at home. As regards our research in a private hospital in Nablus, the 

optimization of the transition from hospital to home gains an integral place in the chain, 

underlining that flawless execution and proper coordination are indeed done throughout 

the discharge process. 

It is going to be very useful to provide insight into how evidence-based practices can be 

applied to findings by Parkes & Shepperd (2000) in their systematic review. Especially 

for a hospital in Nablus, engaging informative insights that perfect and make stronger the 

set protocols of discharge planning provides a proactive approach. It promotes not only 

smooth transition for patients from inpatient care planning to home but also ensures that 

they get adequate support and additional means of recovery in a home setting (Parkes & 

Shepperd, 2000).  

The discharge planning becomes particularly effective in Nablus, where it is aimed at 

improving the entire quality of care and patient satisfaction. The private hospital aims to 

contribute meaningfully toward the general goal by being attentive to coherent discharge 

centering on the patient. The facility is informed by the frameworks of patient-centered 

care and the specific needs of people in the Nablus region.  

Within the context of private hospital settings in Nablus, effective management of 

discharge from patients is not about administrative convenience; rather, it forms a critical 

feature of care that has implications in the long term for safety and resultant health 

outcomes. As Forster et al. (2011) noted, ethical consideration forms the core in the 

formulation of strategies that would reduce risks associated with complications after 

discharge, those especially related to less-than-satisfactory practices in data management. 

These findings agree that private hospitals in Nablus can be in a position to formulate and 

implement interventions for both immediate and long-term risks to patient safety. 

Improvement in the transparency of data and its reliability can aid health professionals in 

protecting their patients from threats to their safety even after being discharged. This 

proactive approach ensures continuity of patient care and builds a safety culture for the 

patients, thus laying the foundation toward a more effective and ethical discharge process 

that will meet the particular healthcare needs of the population in Nablus. 

Expanding on the importance of adequate discharge planning, the input from Kozak, 

Owings, and Hall (2004) sheds light on how national trends in discharges indeed give a 



 

18 

yardstick against which local practices can be measured and improved upon. Though the 

National Hospital Discharge Survey which the authors conducted is from the American 

health care environment, the macroscopic view it offers can be very useful to private 

hospitals in Nablus as they seek to benchmark their strategies against global standards. 

Comparing it with national and international best practices will enable healthcare 

administrators in Nablus to identify the strong points in their discharge planning while 

noting areas that require further refinement. This alignment not only enhances the 

effectiveness of discharge planning but also fosters an environment where practices are 

ever-evolving to meet the most current evidence-based recommendations, thus enhancing 

the quality and safety of healthcare delivery. In this respect, the private hospitals in 

Nablus will be responding not only to the global trends but also to the peculiar needs of 

their patients, thus bringing themselves into the lead category in care-oriented service at 

discharge. 

This brings into focus that a major consideration in discharge planning is the recognition 

of post-discharge complications, especially in surgical patients, as noted by Kosecoff et 

al. and Mitchell, Swift, and Gilbert (1999). Their studies emphasize that the mechanism 

of surveillance is very important in extending beyond the hospital environment, in 

particular, the monitoring for SSI, which has rather big consequences for the recovery 

and quality of life of patients. Adopting the same keen approach in post-discharge 

monitoring from private hospitals in Nablus will reduce the incidence of adverse 

outcomes and protect the patients from preventable complications. Integrating such 

surveillance into the process of discharge ensures not only that patients are discharged at 

the appropriate time, but also that they continue to be adequately supported and monitored 

for any complications well after discharge. This practice underlines a patient-centered 

approach, recognizing the continuum from hospital to home that is so necessary to ensure 

safety and satisfaction for the patient. 

Parkes and Shepperd emphasize that the core of ensuring optimum posthospitalization 

outcomes is careful discharge planning. Translating these insights into practice within 

private hospitals in Nablus would entail establishing an effective, well-coordinated 

process for discharge, including patient education, timely follow-up, and efficient 

transitions of care. Healthcare providers can avoid significant risks of complications and 

readmission by assuring that those patients and their families understand steps that will 



 

19 

be required for continued care at home. An approach like this empowers not only the 

patient, but also assures transition from hospital care to the home environment is easy and 

less traumatic for the improvement in patient satisfaction and overall health outcomes. In 

private hospitals in Nablus, their adoption of evidence-based discharge planning methods 

based on Parkes and Shepperd's research could increase the quality of care provided to 

patients through the globalization of local practices while still catering to regional health 

needs. 

Finally, the "quicker-and-sicker" phenomenon described by Kosecoff et al. is a critical 

issue of the discharge process itself, where patients are being discharged in a more fragile 

state than in the past and requiring more post-discharge care. Such a trend for healthcare 

providers in Nablus implies a difficult balancing act between efficient management of 

hospital resources and the need to prepare patients for going home. In this way, the private 

hospital will be able to assess properly the readiness of every patient and plan the time of 

discharge, with consideration not only of the immediate recovery of the patient but also 

of the risk that might occur after discharge. This careful consideration would reflect a 

commitment to patient-centered care where discharge decisions are informed by a holistic 

view of each patient's health status and support system. Eventually, applications of the 

insights of Kosecoff et al. within the framework of discharge planning in private hospitals 

in Nablus will probably result in fewer complications and readmissions and also in more 

concerns for quality care that would answer the needs of patients in both the short and 

long run. 

In summary, this systematic review by Parkes & Shepperd (2000) gives insights to 

optimize transition from the hospital to the home environment by focusing majorly on the 

role of discharge planning. This will give evidence-based practices to the private hospital 

in Nablus so that their approach is patient-centered toward this phase of the care, thus 

enhancing overall quality of health care and patient satisfaction. 

The study by (Herlitz, et al., 2003) on survival after out-of-hospital cardiac arrest is very 

rich in informational findings that resonate well with our current study, aimed at 

understanding factors associated with the survival status at the time of hospital discharge. 

The perception, however, was not only on the cardiac arrest but other pathological 

conditions and their collective implication on patient discharge times in Nablus. 



 

20 

Data from the study by Herlitz et al. (2003) will therefore become important material in 

relation to this particular topic under consideration, since patient outcomes have a 

complex survival dynamic overall. That being said, understanding factors that may be 

associated with survival will shape the evidence-based practice and ultimate patient care 

in this private hospital in Nablus to the best possible levels. 

By including different medical conditions, we are making the study more general to 

prevailing patient care concerns in Nablus. Although composed of a narrow medical 

event, the inferences to be drawn are relevant inside a wider frame of health delivery. The 

recognition of factors related to survival across the breadth of medical conditions 

empowers the private hospital to tailor its discharge process to the unique needs of 

patients in Nablus, thereby adding value to the healthcare base in more efficient, 

treatment-centered healthcare service. 

In summary, Herlitz et al. (2003) foray into survivalistic consequences is important for 

outlining a parallel with our research goals on the importance of understanding factors 

related to survival up to hospital discharge. It is from this vantage point that our study 

analyzes a number of medical conditions in an effort to offer a detailed overview of the 

timeline through which patients are discharged, with the ultimate goal of contributing to 

improved healthcare quality and patient outcomes in Nablus. 

Petrilli, et al. (2020) recent report on factors predicting COVID-19-related hospitalization 

and critical illness is one of those angles that the pandemic has introduced to a global 

health crisis. Their study, although with different settings and designs, rings a bell on the 

external impacts like pandemics on the discharge process of private hospital patients in 

Nablus. 

Petrilli, et al. (2020) study provides information on the complexities related to patient 

outcomes during a global health crisis and highlights the role of the interplay of external 

factors with healthcare services. Though the focus is on COVID-19, the powerful area of 

reflection is sure to highlight how the healthcare practitioner in Nablus is in constant fluid 

action to realign with the external health crises that will affect patient discharge processes. 

This research, by Petrilli, et al. (2020) is almost an unprecedented way in the setting of 

Nablus, which has to get interest in people regarding what will be the trickle-down effect 



 

21 

of factors in yielding patient discharge times. What ways the private hospital can upgrade 

its preparedness, coordination, and communication on ways of health crisis that becomes 

a source of stringent inquiry to ensure both the continuum of care and patient well-being. 

Based on some of the takeaways from the study results by Petrilli, et al. (2020) the private 

hospital in Nablus can, therefore, come up with survival strategies in external turbulent 

environments to still ensure the effectiveness of the process of patient discharge. Many 

takeaways from the study by Petrilli, et al. (2020) will be directed toward the introduction 

of strategies in response to turbulent external challenges and the assurance of an effective 

process of patient discharge. This, therefore, is a forward-thinking approach that goes in 

line with allegiance to top-level, patient-oriented care service being delivered. 

1.7 Admission and discharge time 

Timing considerations in critical care settings add another critical dimension to the 

perspective forwarded by Zhou et al. (2023) with respect to the effect of admission and 

discharge times on hospital mortality in patients with sepsis. Even as their focus is on 

sepsis, the place of timely discharge in optimizing patient outcomes in Nablus is one such 

study that comes to mind. 

This key finding by Zun, Ibrahim, & Mokhtar (2019) resonates with the idea that strategic 

timing plays an important role in critical care in terms of not only admission but also 

discharge. It brings an urgency to understanding timely discharges in realizing positive 

outcomes for patients after adopting this perspective in our research in Nablus. This study 

has done much to bring into focus the lines of critical care-time and potential mortality 

cost implications by presenting a challenge to health providers in Nablus to review 

discharge practices for improvement. 

The findings from Zun, Ibrahim, & Mokhtar (2019) study, set in a private hospital in 

Nablus and therefore having to make a balance between efficiency and safety, help in the 

construction of an incisive understanding with respect to the role of timing in patient care. 

Evidence-based strategies for the betterment of quality of care and optimizing of patient 

outcomes could be developed by recognition of the implications for discharge times on 

hospital mortality. 

  



 

22 

Conforming its discharge practice to the important timing considerations described by the 

research and incorporating lessons from studies like Zun, Ibrahim, & Mokhtar (2019) the 

Nablus private hospital will be able to keep up. It is in this way that the hospital fulfills 

its responsibility to treat patients with timely, effective, and patient-centered care, hence 

fostering good patient outcomes in critical care settings. 

In a retrospective cohort study, Picard, et al. (2022) present the risk factors for prolonged 

time to hospital discharge following ambulatory cholecystectomy under general 

anesthesia, thereby shedding insight into the enigmatic nature of post-surgical recovery 

and discharge planning. Their study invites considerations on what can prolong the 

discharge time, hence bringing implications for how to optimize postoperative discharge 

in the private hospital setting in Nablus. 

The findings from Picard, et al. (2022) study contribute nuanced insight into multiple 

elements that can influence time to hospital discharge after some specific surgical 

procedures. Turning such a perspective into the study conducted in Nablus, one has to 

take cognizance and respond to factors likely to prolong such discharge times after 

surgery if optimistic outcomes and general patient satisfaction are to be ensured. This 

study will, therefore, encourage benchmarking and continuous improvement in the 

current postoperative discharge practice by healthcare providers in this private hospital, 

taking into account the unique factors at play in the local context. 

The private hospital in Nablus will be guided by insights, such as those by Picard, et al. 

(2022) in order to change postoperative discharge procedures to address any risk factors 

that may arise. All this goes with the commitment of the hospital to making post-surgical 

care efficient and individualized; hence, contributing to positive outcomes and 

experiences among patients. 

The study by Russell, et al. (2017) on the frequency and risk factors for live discharge 

from hospice adds a dimension of care transition that makes it fit within the general 

concept of patient discharge. Although focusing on hospice care, their understanding of 

the factors influencing live discharge offers key insights into the dynamics of 

transitioning patients from specialized care settings. Applying this latter perspective to 

our research in a private hospital in Nablus, the study raises concern about the factors that 

would help influence the transition of patients from hospital care to subsequent settings. 



 

23 

The findings from Russell, et al. (2017) add to the overall understanding of the nature of 

transitions in care, focusing on the factors likely to influence such decisions concerning 

live discharge from specialized care settings. In the context of the private hospital in 

Nablus, identifying these factors will be very critical in the process for healthcare 

providers to optimize the best discharge process, ensuring smoothness in transition for 

the patients. 

The incorporation of insights from studies such as Russell, et al. (2017) may help the 

private hospital in Nablus while strategizing on assessment and addressing of potential 

risk factors that may impact transition from care in a hospital setting. This proactive 

approach will serve to fulfill the ideals that this particular hospital upholds: 

comprehensive, patient-centered care, hence facilitating smooth and positive 

transitions/experiences for persons transitioning from specialized care to subsequent 

settings. 

The study of Moreira, Verga, Barbato, & Burghi (2017) on the effect of the timing of 

admission and discharge from an intensive care unit offers an important perspective to 

considerations about timing in a critical care setting. As this is an ICU-based study, it 

raises consideration of how timely transitions—here, from intensive care—impact patient 

outcomes. This thus translates to, in understanding the importance of timely discharge, 

optimizing patient outcomes becomes important in a private hospital in Nablus. 

Incorporating insights from studies like Moreira, Verga, Barbato, & Burghi (2017) the 

Nablus private hospital will be in a better position to improve its practices regarding the 

discharge of patients from intensive care. This was in tandem with active interest by the 

hospital in ascertaining high quality, timely, and patient-centered care, thus positively 

influencing the outcome in patients discharged from intensive care settings. 

In this regard, Whitney & Chuang (2016) examined the relationship between insurance 

and 30-day readmission rates of patients discharged from acute care hospitals to hospice 

services. Their focus is on hospice services, but generally, the study gives considerations 

related to insurance and readmission issues that help reflect how the insurance-related 

factors may affect post-discharge outcomes in our study setting within Nablus. 

  



 

24 

Such findings from the study by Whitney & Chuang (2016)  elucidate the interrelationship 

of insurance-related factors on the likelihood of readmissions within a specified period. 

The effect of insurance-related factors on the post-discharge outcomes thus holds 

paramount concern for healthcare providers in the private hospital setting in Nablus, 

where optimum patient care remains the goal of continuum. 

The private Nablus hospital will assess and take appropriate action on all possible 

insurance-related variables that may impact readmission rates, drawing from studies such 

as Whitney & Chuang (2016). This will be in line with its concern for full and continued 

care, to ensure that each patient, in the environment of Nablus, has the best possible 

outcome after discharge. 

The nationwide study done by Teno, Plotzke, Gozalo, & Mor (2014) focused on the live 

discharge from hospice and added data about the factors involved in live discharge 

situations and the consequences of such. Although this study was carried out with the 

setting of hospice care, it raises thought on the variables that might lead to the discharge 

of a patient and the associated outcomes. If we translate this perspective to our research, 

understanding factors that would impact patient discharge will be of relevance in 

optimizing the best care within the private hospital setting of Nablus. 

These results from a study by Teno, Plotzke, Gozalo, & Mor (2014) elucidate the intricate 

dynamics that factor into live hospice discharges, underscoring the need to consider 

factors that may influence discharges and their possible implications. In a private hospital 

in Nablus, it is important to understand these factors in the setting wherein patient 

transitions and outcomes are paramount. 

The private hospital in Nablus will be impelled to fashion strategies to assess and manage 

the many factors that may affect the discharge of patients from hospitals, drawing upon 

the findings of this and other studies such as that by (Teno, Plotzke, Gozalo, & Mor, 

2014). It will be in line with the vision of this hospital for unique, patient-centered 

healthcare, all toward the better management of patients' transition from hospital care. 

The cohort study by Delgado-Rodrguez, Gmez-Ortega, Sillero-Arenas, & Llorca (2001) 

on the surgical-site infections diagnosed after hospital discharge is very much relevant to 

emphasize the need for monitoring for post-discharge complications. Their focus is on 



 

25 

surgical-site infections, but the very elements in this research bring awareness about the 

variables which might lead to post-discharge complications and add to our present 

understanding of the complexities surrounding the discharge of patients from a private 

hospital in Nablus. 

The findings from the study by Delgado-Rodrguez, Gmez-Ortega, Sillero-Arenas, & 

Llorca (2001) place on high alert the occurrence of post-discharge complications, most 

especially in surgical-site infections. In the setting of a private hospital in Nablus, with a 

paramount concern for the safety of its patients, it becomes incumbent upon healthcare 

providers to understand and address various factors likely to contribute to post-discharge 

complications. 

The private hospital in Nablus could benefit from follow-up practices upon discharge and 

its prevention strategies by reflecting on the insights from studies such as (Delgado-

Rodrguez, Gmez-Ortega, Sillero-Arenas, & Llorca, 2001). By engaging in these proactive 

steps, the safeness of quality healthcare provision that the hospital strives to attain is 

maintained, thus yielding positive outcomes and experiences amongst patients in the 

context of Nablus. 

It aims to plug a serious lacuna that exists in literature available today on the effect of 

quantitative factors on discharge times in a private Nablus, West Bank, Palestine, 

hospital. More broadly, this research is designed to make an important contribution 

toward literature concerning unique dynamics of health care delivery in a regional context 

set by unique cultural, logistic, and administrative considerations. This article focuses on 

the quantitative elements surrounding the discharge of patients at the end of life, in an 

effort to better understand all the factors that affect timely discharges. This has an impact 

on patient satisfaction, hospital efficiency, and resource allocation. 

Specific objectives will be the identification and analysis of relationships between such 

factors as the severity of the patient's medical condition, delays in insurance approval 

processes, bed availability in the hospital, and time taken to get the patient discharged. 

Based on these factors, this study sets out to investigate systemically with a view to 

establishing evidence-based strategies for optimizing the process of patient discharge in 

a private hospital setup in Nablus. The present study thus aims to make a contribution not 

only to the development of a local healthcare system, but also to extend insight into the 



 

26 

interplay of facilitating and impeding factors of patient discharge times in the context of 

a Palestinian public hospital. The results of this study should help enlighten health 

professionals, policymakers, and hospital administrators in their attempt to modify patient 

care, operational processes, and hence improve the quality of health care in the region. 

1.8 The Impact of Insurance on Patient Discharge Time from Hospitals 

Discharge from hospitals is one of the most crucial phases in the delivery of health care 

services. It is significant in the determination of both the outcomes of patients after 

discharge and the system's healthcare efficiency. This review is aimed at identifying the 

relationship between health insurance and the discharge time of patients. Therefore, it is 

important for the quality of care and hospitals to operate appropriately by modification of 

this complex relationship. The synthesis of the findings by the above stated studies as to 

whether insurance affects the timing of patient discharge, thus, reviews the implications 

these throw to health outcomes. 

Forster, Murff, Peterson, Gandhi, & Bates (2003) looked at the incidence and the degree 

of adverse events affecting patients after discharge. The article did not address insurance 

directly, but it did lay some basis for the issues and complications that insurance may 

encounter for patients after discharge from the hospital. Van Walraven, Seth, Austin, & 

Laupacis (2002) researched whether the availability of the discharge summary at post-

discharge visits affected the readmission to the hospital. This also does not directly 

address insurance, but its finding does add to general coordination of post-discharge care. 

Ayanian, Kohler, Abe, & Epstein (1993) reviewed the treatment and clinical outcomes of 

insured and uninsured women with breast cancer. It therefore has general implications in 

that the role of insurance may impact disease-specific outcomes, necessarily with 

implications for generalized care. Hernandez, et al. (2010) conducted a study on the 

association of early physician follow-up with readmission; this work underlines the 

importance of post-discharge care. Not exclusively focused on insurance, although their 

findings have obvious implications for the understanding of how timely follow-up—often 

influenced by insurance—affects hospital readmissions. 

  



 

27 

In the South African setting, Dyers, Evans, Ward, Du Plooy, & Mahomed (2016) 

considered the readiness of central hospitals for National Health Insurance in 2016; 

specific to the South African setting, their evaluation of coding quality against electronic 

patient discharge records sheds some light on the broader issue at hand: data accuracy 

and management, an important consideration when the role of insurance in patient 

discharge comes into the picture. 

The article by Forster, Murff, Peterson, Gandhi, & Bates (2003) not only raises questions 

about the difficulties at time of discharge, but also insurance-related variables that may 

exacerbate or mitigate these difficulties. Elucidation as to how insurance affects adverse 

events in this period further may be helpful in pointing out what parts of care are affected 

by the quality of insurance coverage. Like it would say, "availability of insurances for 

follow-up visits or medications required during after-care is also a consideration which 

will contribute towards the patient's recovery trajectory post-discharge from the hospital".  

Illumination of information flow from the hospital to the post-hospital care is the 

availability of summaries at the time of discharge in the study by (Van Walraven, Seth, 

Austin, & Laupacis, 2002). The study does not directly involve researching insurance; 

thus, it would not influence effective communication in most cases. A larger scope that 

was included could be related to insurance coverage and the effect on the quality and 

availability of information post-discharge, which would provide more impetus to develop 

ways to enhance care continuity and reduce readmission rates while improving patient 

outcomes. 

Ayanian, Kohler, Abe, & Epstein (1993) study on the link between health care coverage 

and clinical outcomes for female patients with breast cancer added the disease-specific 

dimension of the general question of insurance and health care outcome. Applying this 

perspective to a much broader population—a cohort of people with health conditions—

will potentially give us a global picture of how insurance affects recovery processes. Such 

design can actually reveal some shared behavioral patterns or unique issues of some 

particular health conditions, thus leading to the development of more tailored health care 

policies and interventions likely to work. 

  



 

28 

The article by Hernandez et al. (2010) regarding the relationship between early physician 

follow-up and readmission gives appropriate context by which the individual can 

understand the role of insurance in post-discharge care. Timely follow-up is frequently 

insurance-dependent, and further explication of that interaction may help to demonstrate 

how insurance structures influence the continuity and quality of care. The other thing is 

that generalizability across systems and insurance models may elucidate how post-

discharge care improvement interventions can be adapted to the varied insurance 

landscapes. 

In the South African context, Dyers, Evans, Ward, Du Plooy, & Mahomed (2016) offer 

an assessment of readiness for National Health Insurance that speaks to the broader 

context: health system readiness. This orientation sets the agenda for questions related to 

institutional infrastructures and policies required for the effective discharge of patients, 

and thus raises the stakes with respect to insurance-related interventions. Such data could 

yield the discussion as to how various healthcare systems, even those that differ in 

insurance models, manage the discharge of their patients. Thus, it is pertinent to the global 

discussion of healthcare optimization. 

Finally, although it had a lot of insight, there was somewhat of a literature gap in terms 

of a direct scrutiny with regard to the nature of insurance and its impact on the time 

patients spend until discharge. This will be up to the researchers to design future studies 

to definitively demonstrate how insurance, in both type and extent of coverage, impacts 

the timing and quality of patient discharge. Further analysis on how insurance interacts 

with other factors, such as SES, comorbidities, or geographical location, can help in 

obtaining a better, fuller understanding of the dynamics involved. Such research 

initiatives may be invaluable to help the policy levels and health care practice formulate 

decisions that can help improve the best possible outcomes during this critical phase of 

patient discharge. 

Efficiently managing the patient's discharge process is another critical area that impacts 

patient satisfaction and generally the quality of healthcare services. In the context of 

Nablus, West Bank, Palestine, where the need for good healthcare is increasing, there is 

a striking lack of comprehensive studies about the factors that affect the discharge times 

of the patients from a private hospital. The frequency with which previous studies were 



 

29 

conducted on patient satisfaction (Al Sharif, 2008) and experiences with hospital services 

Takruri, Radwan, El Jabari, Nawajah, & Hassan (2023) can rarely be noted, so there is a 

gap in knowledge of quantitative factors that influence timely release of patients from 

healthcare facilities. 

Medical conditions of the hospitalized patients have been drawn through an assessment 

by Sawalha (2009), while medication adherence and its impact on outcomes have been 

studied by (Qadah, 2014). What has neither been studied nor established, and most 

critically the points of intersection and demarcation, are the medical conditions with the 

insurance-related factors and logistics intertwined and embedded within and how each of 

the three respectively and collectively set, interact, and contribute to the patient discharge 

time. Measuring and quantifying as such is, therefore, necessary to increase the quality of 

delivery in the private hospitals in Nablus. 

Furthermore, the variables associated with the reported times of discharge of the patient 

cases, as reported from the private hospitals located in Nablus, West Bank, State of 

Palestine, will be considered. In relation to the medical condition, insurance-related 

variables, and logistical issues, it is supposed that the study measures their relative impact 

on the efficiency of the patient discharge process. Consequently, it will be independent, 

the time patterns, correlations as well as possible determinants that will be taken by the 

patients to be discharged from the private hospital, due to the strict appraisal of the 

patients' record. 

This study has concluded that it was undertaken exclusively in Nablus and can contribute 

valuable local insights to inform health practice. The research will be quantitative, using 

data from patient records, insurance-related anamnesis, and records of a logistical nature. 

Such data shall be analyzed to understand properly what goes on in the time of discharge 

of the patient so that improvements in the process of discharge are evidence-based. 

This study will fill this gap in knowledge since it will be a quantitative study of the times 

patients are discharged from private hospitals after the declaration of the single-pilot 

concept and steps toward good quality healthcare with high levels of patient satisfaction. 

It is hoped that the findings in the current study would adequately bring to the attention 

of health-care service providers, administrators, and the policymakers so that, with regard, 

such interventions can be implemented to improve efficiency in the patient discharge 



 

30 

process, hence bettering overall health delivery services provided in private hospitals in 

Nablus, West Bank, Palestine. 

This research aims to identify the factors that affect the time of discharge of patients from 

private hospitals in Nablus, West Bank, Palestine, filling some lacuna in the literature. 

Taking support from primary studies of (Teno, Plotzke, Gozalo, & Mor, 2014); (Delgado-

Rodrguez, Gmez-Ortega, Sillero-Arenas, & Llorca, 2001) which called for linking 

medical conditions with logistic delays pertaining to time of discharge, the facilitators are 

measured in a facilitative way so that improved patient outcomes can be brought out with 

regards to the hospitals management. Put differently, it will gain insight into the dynamics 

of discharging patients within a regional context and hence develop evidence-based 

strategies for the improvement of discharge and quality of care. 

This will also extend to the insurance coverage implication for post-discharge, in general, 

based on the related works' findings, tagging it an influence on follow-up care and patient 

outcomes. The current study is going to look profoundly into how insurance status, 

medical condition, and discharge logisticians play in an investigation of how variables of 

such kind interact to determine discharge times when taken jointly. This will help gain 

insight into the discharge procedures and general satisfaction of patients in Nablus, 

thereby providing enlightenment to health care providers and policy makers in coming 

forth with pointed interventions in these and other private hospitals. 

 

  



 

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Chapter Two 

Methodology 

2.1 Introduction  

This chapter will treat the description of the study method, the study sample and 

population, the study tool, a description o the procedures that were done to codify the 

study tool, and its application it describes the statistical procedures used in the analysis 

of data and extraction of results 

2.2 Study design 

The study: A retrolective observational study in a private hospital in the Nablus, West 

Bank, Palestine, will identify and assess factors affecting the time of discharge of patients. 

The study mainly uses quantitative nature data sources. Historical data can provide an 

insight on possible investigation of patterns of patient discharges and related factors over 

two years of time. 

2.3 Data Sources 

a.  Patient Records: Data were collected from EHRs and databases maintained by the 

private hospital that contain all relevant patient demographic information, disease 

conditions, admission and discharge dates, clinical orders, and other important 

relevant quantitative variables. 

b.  Billing and Insurance Records: Data pertaining to an individual regarding insurance 

details, billing information, and time taken for prior authorization were extracted 

from the financial records of the hospital. 

c.  Logistic records: bed availability records, transportation arranging, and coordination 

between the hospitals. 

2.4 Sample Size 

Given a population size of 16,000 patients, a desired level of confidence of 95% (Z = 

1.96), and a desired margin of error of 5% (E = 0.05), you can calculate the sample size 

using the formula: 

- n is the sample size (which we want to find). 



 

32 

- Z is the Z-score for a 95% confidence level, which is 1.96. 

- σ is the estimated population standard deviation (assumed to be 0.5 for a conservative 

estimate). 

- E is the margin of error, which is 0.05 (5%). 

- N is the population size, which is 16,000. 

Calculate the sample size: 

Sample size: the actual sample size used in this study was 376 patient record. Estimation 

of sample size was done through the estimation formula, which considered a population 

size of 16000 patients a desired level of confidence of 95%, and a margin of error of 5 %. 

It was unnecessary to subtract the finite population correction factor; hence the 

approximate sample size was 376 to hold representation. 

This were achieved by the application of the technique of randomization of samples from 

the larger population in the research. A computer-based random number generator or 

some other process of randomization is applied to randomize the sample. The study does 

not apply selectivity and, therefore, the overall generalizability of the results is universal 

to a greater population. 

A randomly selected sample was taken from the history data of patients who match the 

given set of two years.  

2.5 Study Population  

Inclusion Criteria: 

- Patients Admitted to the Private Hospital: This will include patients who were 

admitted to the private hospital in Nablus for a two-year period earmarked.  

- All Age Groups: Patients from all age groups were taken note of in an attempt to 

make the study more generalized within the limits of the patients going through the 

portals of the hospital. 

- Varied Medical Diagnoses: All types of medical diagnosis and conditions were taken 

into account to determine the varied need of medical and time taken in discharge. 

- Both the insured and the non-insured patients were taken into consideration in the 



 

33 

analysis when determining the impacts of different insurance-related variables on the 

discharge times. 

- Other Insurance Companies: Patients that have registered with other types of 

insurance companies or categories to study the influence caused by the different 

policies in insurance on discharges. 

- All Occupancy Scenarios: Patients with their admissions during highs and lows of 

both bed occupancy periods, to capture the dependence relationship between the 

availability of beds and discharge time. 

- Patients with Incomplete Data: These are the people on whom data is incomplete or 

lacking on the variables to be analyzed such that, for instance, if there are exclusion 

criteria, then the patients with exclusion criteria, like those with incomplete discharge 

times, are excluded from the study. 

- Patients in Other Hospitals: Patients admitted to hospitals other than the identified 

private hospital will not feature within the sample. 

- Patients with Non-Medical Admissions: The admissions for reasons other than 

medical but for administrative or non-clinical purpose shall be excluded to the review 

as the same may not send or deliver the message that the study is meant to focus 

upon.  

- Patients with Rare Conditions: When the patient presents extremely rare or unique 

medical conditions that cannot be applied to the general population, he/she were 

excluded. 

- Patients with Atypical Insurance Situations: Patients with highly individualized 

insurance arrangements that do not typify the general condition of most patients were 

excluded. 

2.6 Data collection tool 

This data collection tool was serve as secondary data from the selected hospital and were 

included the major variables were have identified in the methodology: patient 

demographics, medical conditions, admission and discharge details, clinical orders, 

billing and insurance information, and logistics arrangement.  

 



 

34 

Permission and Access: 

Permission to use and access secondary data for research was provided by the hospital's 

management of the private hospital. 

Permission was granted for the researcher and data analysts, who were educated in the 

hospital, to access the data and retrieve data held in the electronic health records, data 

from administrative databases, and financial records of the hospital. 

Data Extraction: 

Retrospective data extraction: the focus was on the gathering of information regarding 

patient demographics, medical conditions, admission and discharge, clinical orders, and 

billing and insurance details, including logistic arrangements. 

Data was for a two-year period to ensure that it is not only adequate but also representative 

of the patients who were admitted and discharged from the hospital. 

Data Analysis: 

Exploring the relationship between the variables and times taken to discharge a patient 

through the application of descriptive and quantitative nature methods of data analysis. 

Statistical methods like regression analysis were applied in determining the impact the 

factors had on the efficiency to discharge a patient and variability of delays in the hospital. 

Ethical Considerations: 

The study was conducted under the achievement of ethical guideline and standards on the 

conduction. 

Patients' information was made anonymous. It was made confidential and, at the same 

time, the privacy of the patient was kept. 

This methodology made possible the structured collection and analysis of secondary data 

taken in a private hospital in Nablus to study factors affecting patient discharge times. 

Study depended upon the derivation of the maximization process of improvements in 

patient care during this period within a setup environment of a closely data-extracted, 

cleaned, and closely analyzed focused hospital. 



 

35 

2.7 Validity and Reliability 

In adherence to the dictates of a valid research, quantitative method of data collection was 

conducted in conformity with the conventional norms and ethics of research.  

2.8 Statistical analysis 

Descriptive Analysis: 

For the categorical study variables, frequencies and percentages were computed for 

patient's condition, occurrence of complications in patients, and type of care. The 

variables of age and length of stay were categorized into intervals, and frequencies along 

with percentages were computed based on these intervals. These were done only for 

summarizing and describing the study variables. 

Quantitative Analysis: 

This provided the ground for carrying out a statistical analysis, which ranged from simple 

and multiple linear regression models that brought into play the variable relations between 

patient discharge time and the patients' conditions, occurrence of complications in 

patients, type of care, and age. This quantitative analysis is in search of important 

predictors of such times. 

  



 

36 

Chapter Three 

Results 

In this chapter, the study's outcomes are showcased through addressing its research 

inquiries and testing its hypotheses. The data underwent processing and coding, followed 

by the implementation of both simple and multiple linear regression analyses using SPSS 

software. 

3.1 Results 

Characteristics of the sample: 

Table 1 

Demographic Characteristics of Patients 

Variables Frequencies Percentage 

Gender 

male 224 59.4% 

female 153 40.6% 

Total 377 100% 

Age 

Less than 18 54 14.3% 

18-33 78 20.7% 

34-49 55 14.6% 

50-65 104 27.6% 

more than 65 86 22.8% 

Total 377 100% 
 

The table (1) displays the distribution of patients by gender and age groups. Males account 

for (59.4%) of the sample, while females make up (40.6%). The largest age groups are 

50-65 and over 65 (50.4% combined), and the smallest group is under 18 (14.3%). 

  



 

37 

Table 2 

Distribution of Patients by Accommodation Type in a Hospital 

Variables Frequencies Percentage 

Type of Care 

First Class 34 %9.0 

Third Class 193 %51.2 

Incubator 21 %5.6 

Suite 13 %3.4 

Cardiac Care 33 %8.8 

Intensive Care 83 %22.0 

Total 377 100%  
 

The table shows the distribution of patients across different accommodation types in a 

hospital. Third Class accommodation is the most common (51.2%), followed by Intensive 

Care (22.0%). First Class, Suite, Incubator, and Cardiac Care have smaller percentages 

of patients. 

Table 3 

Distribution of Patients by Patient's Condition in a Hospital 

Variables Frequencies Percentage 

Patient's condition 

Emergency 334 %88.6 

elective 43 %11.4 

Total 377 %100 
 

The table shows that most patients (88.6%) were admitted under emergency conditions, 

while a smaller percentage (11.4%) were admitted electively. 

Table 4 

Distribution of Patient Length of Stay in the Hospital 

Variables Frequencies Percentage 

Length of Stay 

less than 4 days 285 75.6% 

4-12 68 18.0% 

13-21 14 3.7% 

more than 21 days 10 2.7% 

Total 377 100% 



 

38 

The table shows that most patients (75.6%) have a length of stay in the hospital of less 

than 4 days, indicating a trend towards shorter hospitalizations. Fewer patients stay for 4-

12 days (18.0%), 13-21 days (3.7%), or more than 21 days (2.7%). 

Table 5 

Occurrence of Complications in Patients 

Variables Frequencies Percentage 

Complications Occurrence 

NO 367 97.3%     

YES 10   2.7% 

Total 377 100% 
 

Table 5 provides data on the occurrence of complications among patients. It shows that 

(97.3%) of patients did not experience complications, while only (2.7%) did. 

3.2 Study Hypothesis and the results  

Hypothesis  1 : Age has a significant impact on the length of stay in the hospital. 

Table 6 

Linear regression between Age (in years) and Length of stay in the hospital (in days) 

Dependent  Independent  B  sig    Result  

length of stay Age 0.077 0.000 0.110 Reject the null hypothesis  

 

From the results presented in Table (6), the p-value of less than 0.05 indicates a significant 

positive relationship between Age and Length of stay in the hospital, with a coefficient 

of (B=0.077). This suggests that for each additional year of Age, the Length of stay in the 

hospital increases by approximately (0.077) days. Age explains approximately 11% of 

the variation in the Length of stay in the hospital. 

  



 

39 

Hypothesis  2: There is a significant impact of the patient's condition on the length of stay 

in the hospital. 

Table 7 

Linear regression between patient's condition and Length of stay in the hospital (in days) 

Dependent  Independent  B  sig    Result  

length of stay patient's condition 2.417 0.016 0.015 Reject the null hypothesis  

 

The results from Table (7) reveal a statistically significant impact of the patient's 

condition on the length of stay in the hospital, indicated by a p-value of less than 0.05. 

Specifically, patients admitted under emergency conditions have a longer length of stay 

by approximately 2.417 days compared to elective admissions. Although the variability 

explained by the patient's condition is modest at 1.5%, this relationship is deemed 

significant, leading to the rejection of the null hypothesis. 

Hypothesis  3: The occurrence of complications in patients has a significant impact on 

the length of stay in the hospital. 

Table 8 

Linear regression between occurrence of complications and length of stay in the hospital 

Dependent  Independent  B  sig    Result  

length of stay 
occurrence of 

complications 
11.649 0.000 0.091 

Reject the null 

hypothesis  
 

The results from Table (8) indicate a significant impact of the occurrence of complications 

on the length of stay in the hospital, as evidenced by a p-value of 0.000. The coefficient 

(B=11.649) suggests that the presence of complications increases the length of stay by 

approximately 11.649 days. While the R-squared value indicates that 9.1% of the 

variability in the length of stay can be explained by the occurrence of complications 

  



 

40 

Hypothesis  4: The type of care  has a significant impact on the length of stay in the 

hospital. 

Table 9 

Linear regression between type of care and length of stay in the hospital 

Dependent Independent B 
Sig for each 

variable 
F Sig.  Result 

length of 

stay 

Incubator 7.601 0.000   

0.156 

Reject the 

null 

hypothesis  

Cardiac Care 6.544 0.000 23.06 0.000 

Intensive Care 2.692 0.000   
 

Table (9) indicates that the type of care has a major influence on hospital stay duration. 

The length of stay for patients in the incubator, cardiac care, and intensive care units is 

significantly longer (7.601 days, 6.544 days, and 2.692 days, respectively), as shown by 

the p-values (p =.000) for each variable.  This association is further supported by the R-

squared value (.156), which indicates that the type of care explains 15.6% of the variation 

in duration of stay. The null hypothesis is therefore rejected. 

Main Hypothesis : 

Table 10 

Linear Regression Analysis of Variables Impacting Length of Stay in the Hospital 

Dependent Independen