SPSS Research

Assignment
A RESEARCH ON TIME SPENT IN THE EMERGENCY DEPARTMENT
IN FORD HOSPITAL IN 2018

SUBMITTED BY:
PUNEETH SHASTRY CHANDRASHEKARAIAH HANIKE (19210205)
ABHIJIT MADHUSOODANAN (19212021)
GAURAV TIWARI (19213251)
 Declaration on Plagiarism

Name PUNEETH SHASTRY CHANDRASHEKARAIAH

HANIKE (19210205)
ABHIJIT MADHUSOODANAN (19212021)
GAURAV TIWARI (19213251)

Programme MSBM
Module Code MT5113
Assignment Title SPSS Research Assignment
Submission Date 13/03/2020
Module Co-Ordinator Mr. Gerry Conyngham

I/We declare that this material, which I/We now submit for assessment, is entirely my/our
own work and has not been taken from the work of others, save and to the extent that such
work has been cited and acknowledged within the text of my/our work. I/We understand
that plagiarism, collusion, and copying are grave and serious offences in the university and
accept the penalties that would be imposed should I engage in plagiarism, collusion or
copying. I/We have read and understood the Assignment Regulations. I/We have identified
and included the source of all facts, ideas, opinions, and viewpoints of others in the
assignment references. Direct quotations from books, journal articles, internet sources,
module text, or any other source whatsoever are acknowledged and the source cited are
identified in the assignment references. This assignment, or any part of it, has not been
previously submitted by me/us or any other person for assessment on this or any other
course of study.
I/We have read and understood the referencing guidelines found at
http://www.dcu.ie/info/regulations/plagiarism.shtml,
https://www4.dcu.ie/students/az/plagiarism and/or recommended in the assignment
guidelines

Name: Puneeth Shastry Hanike Date: 13/03/2020

Gaurav Tiwari
Abhijit Madhusoodanan

1|Page
 Table of Contents
S.No. Chapters Page No.
1 Introduction 3
1.1 Objectives of the Study 3
2 Research Methodology 4
2.1 Research Design 4
2.2 Sampling Design 4
3 Findings 5
3.1 Data Interpretation 5
3.2 Limitations of Regression Model 16
3.3 Suggestion for Model Improvement 17
4 Conclusions 18
5 References 19
6 Appendix 20

2|Page
 1. Introduction:
Emergency departments (ED) are an essential and diverse hospital field and are the
key point of entry into the healthcare system. With the increase in life expectancy, the aging
of the population and a larger number of health issues, ED continues to demand more. If
hospitals, and more precisely ED, are not ready, this will increase crowding of emergencies,
creating a problem for authorities and hospital management as resources are limited and
can have implications for the length of stay of the patient, waiting times and therefore
patient experience.
Time spent in ED is the second most referred patient experience trend which
suggests that to achieve greater patient satisfaction, this field requires intervention to
improve the quality of care and the efficiency of the resources. This can be done with
Predictive Analytics (PA), which can increase the organizational efficiency and quality of the
ED services.
Time spent forecasting ED will help clinicians prioritize patients and change workflow
to reduce spent time. Big data refers to large volumes of high-speed, complex and variable
data, which require advanced techniques and technologies to collect, store, transmit,
handle and analyse data.
Grounded on the points above, this report describes the different kinds of patients
who have visited the Fords Hospital Emergency Department in 2018, the data differs with respect
to the gender, age, severity of condition and time spent in the emergency department. This research
is aimed to help the hospital to give the insight on the kinds of patients that are visiting the
emergency department so that it would help the hospital’s decision makers to improve the service
quality by giving them more insights on the time spent in ED by considering several dimensions.

1.1. Objectives of the Study:

Some of the objectives of the project was:

 To analyse the data provided and to find patterns within it.

 To identify if there is any significant difference in the time spent in the emergency
department with regards to the different variables provided.
 To identify which are the variables that are impacting the time spent in the
emergency department.

3|Page
 2. Research Methodology:
Research methodology is the specific procedures or techniques used to identify,
select, process, and analyse information about a topic. In a research paper, the
methodology section allows the reader to critically evaluate a study’s overall validity and
reliability (University of the Witwatersrand, 2020). According to Clifford Woody,” Research
comprises defining and redefining problems, formulating hypothesis or suggested solutions,
collecting, organizing and evaluating data, making deductions and reaching conclusion and
further testing the conclusion whether they fit into formulating hypothesis” (A Study of
Information Security policies, P-58).

2.1. Research Design:

Research design is the framework of research methods and techniques chosen by a
researcher. The design allows researchers to hone in on research methods that are suitable
for the subject matter and set up their studies up for success (Bhat, 2020).
The design of a research topic explains the type of research (experimental, survey,
correlational, semi-experimental, review) and also its sub-type (experimental design,
research problem, descriptive case-study) (Bhat, 2020).
The Research Design used in this study was descriptive in nature.
2.2. Sampling Design:
A sample design is the framework, or road map, that serves as the basis for the
selection of a survey sample and affects many other important aspects of a survey as well. In
a broad context, survey researchers are interested in obtaining some type of information
through a survey for some population, or universe, of interest (Lavrakas, 2008).
The Sampling design used here is Stratified Sampling Technique.

 Universe: The universe chosen for the research study is the patients who visited the
Fords Hospital Emergency Department in 2018.
 Sample size: Number of the sampling units selected from the patients visited is the size of
the sample. Sample of 500 patients were chosen from the patients list who visited in 2018.

4|Page
 3. Findings:

3.1. Data Interpretation:

The following figures gives us findings as per the data provided.
(a) Generate the relevant univariate and bivariate descriptive for this data.
Univariate Analysis: “Univariate analysis is the simplest form of analysing data. “Uni”
means “one”, so in other words your data has only one variable. It doesn’t deal with causes
or relationships (unlike regression) and it’s major purpose is to describe; it takes data,
summarizes that data and finds patterns in the data” (Statistics How To, 2020).

Figure: Severity of Condition

From the above figure, we can determine that the patients of severity level 3 have
been visited the hospital more, which is around 63.6% (315) of the total patients visited.
14.9% (74) of the patients with severity level 2, 13.1% (65) of the patients with severity level
4, 5.7% (28) with the severity level 5 (life threatening) and 2.6% (13) of the patients with
severity level 1 (minor) has visited the Ford Hospital Emergency Department in 2018.

Figure: Histogram of Age of Patients

From the above curve, it is clearly understood that the data is normally distributed as
it forms a bell-shaped curve with its mean, median and mode lies at the centre. Above figure
shows that the patients aged between 20-80 years are visiting more.

5|Page
 Figure: Histogram of Time spent in emergency department (Hours)

From the above curve, it is clearly understood that the data is skewed right as its
mean vale is largest, while the mode value is the smallest. The above figures show that
around 400 patients spent less time in the emergency department of the Ford Hospital.

Figure: Percentage of patients visited on weekday

Above figure displays percentage of patients visited on different days. Among all the
days, around 16.4% (81) patients have visited the ED, followed by 14.7% (73) on Saturday,
14.5% (72) on Monday and Wednesday, 13.9% (69) on Tuesday and Thursday, and 11.9%
(59) patients on Sunday respectively.

Figure: No. of patients visited on each month

6|Page
 Above figure showcases the no. of patients that have visited the Ford Hospital ED
between Jan-Aug. 303 patients (61.2%) have visited the ED in January, 93 (18.8%) patients in
February, 65 (13.1%) in July, 18 (3.6%) in August, 6 (1.2%) in April and June, and 4 (0.8%) in
March respectively.

Figure: No. of patients admitted and not admitted to Ford Hospital in 2018

Figure above shows the no. of patients admitted or not admitted to the Ford Hospital
Emergency Department after their visit in 2018. Among 495 patients, 379 patients (76.6%)
didn’t admitted to the hospital. Whereas, 116 patients (23.4%) got admitted to the hospital.

Figure: No. of patients visited based on gender

Above figure indicates the no. of patients visited based on gender to the Ford
Hospital. Among 495 patients in total, 259 (52.3%) were Males and 236 (47.7%) were
Females.

Figure: Gender * Admitted to Hospital Crosstabulation

Above figure represents the crosstabulation of Gender * Admitted to Hospital.

Among 379 patients who didn’t admitted to the hospital, 196 were Male and 183 were
Female. When it comes to the patients who admitted to the hospital, 63 were Male and 53
were Female.
Errors in the Data Provided:
There were 5 errors in the data, where the age and gender were not in the way it
was defined in the variable view column. Below are the errors we removed before
conducting this research.

7|Page
(B) Use statistical tests to test the following hypotheses
(i) Is there a significant difference in the amount of time spent time on average in the
emergency department by males and females?

Figure: Group Statistics

8|Page
 Figure: Independent Samples Test

T-Test: “The t test is one type of inferential statistics. It is used to determine whether
there is a significant difference between the means of two groups” (UCONN, 2020).
From the results of the above T-test, we can see that the group means are
statistically not different because the value in the "Sig. (2-tailed)" row is more than 0.05.
Looking at the group statistics table, we can see that the time spent in the emergency
department by males are less then compared to the females.

(ii) Is there a significant difference in the amount of time spent time on average in the
emergency department by patients arriving on different days?

9|Page
 Figure: One-way Anova

Anova Test: “An ANOVA test is a way to find out if survey or experiment results are
significant. In other words, they help you to figure out if you need to reject the null
hypothesis or accept the alternate hypothesis” (Statistics How To, 2020).
One-way or two-way refers to the number of independent variables (IVs) in your
Analysis of Variance test.

 One-way has one independent variable (with 2 levels). For example: brand of cereal,
 Two-way has two independent variables (it can have multiple levels). For example:
brand of cereal, calories. (Statistics How To, 2020).
The One-way Anova test results showed that there was statistically no significant
difference on the amount of time spent by the patients in the emergency department
arriving on different days, with the significance value of 0.470 (i.e., p=0.470) which is above
0.05.

Figure: Kruskal-Wallis Test

Kruskal-Wallis Test: “The Kruskal-Wallis H test (sometimes also called the "one-way
ANOVA on ranks") is a rank-based nonparametric test that can be used to determine if there
are statistically significant differences between two or more groups of an independent
variable on a continuous or ordinal dependent variable” (Leard Statistics, 2018).
The Kruskal-Wallis test shows the mean rank value for the time spent on the
different weekdays, with the mean rank value of 228.21 on Monday, 212.51 on Tuesday,
227.32 on Wednesday, 231.13 on Thursday, 205.81 on Friday and 208.92 on Saturday
respectively.
(iii) Is there a difference in the proportion of males and females who are admitted to
hospital?

10 | P a g e
 Figure: Chi-Square Test

Chi-Square Test: “Chi square is a calculation used to determine how closely the
observed data fit the expected data” (Study.com, 2020).
From the results of the Chi-Square tests, by considering the results from the
“Pearson Chi-Square” row, we can see that X (1) =0.240 and p=0.624. This tells us that there
is significantly no difference in the proportion of males and females who were admitted to
the hospital.

Figure: Gender * Admitted to Hospital Crosstabulation

From the above table we can see that 54.3% of male and 45.7% of female patients
were admitted to the hospital.

(C) Develop a Regression Model

Regression Model/Analysis: “Regression analysis is a way of mathematically sorting out
which of those variables does indeed have an impact” (Gallo, 2015).

Assumptions:

11 | P a g e
  There must be a linear relationship between dependent and independent
variable.
 Dependent variable must be measured on continuous scale (interval or ratio
variable) and independent variable can be either continuous or categorical.
 Data should not have multicollinearity i.e. independent variables should not be
highly co-related.
 Residuals or errors must be normally distributed.
 There should not be any outliers or high leverage points.
 The data used must represent homoscedasticity.

Measurement Levels of variables:

We have 5 variables, including 4 independent variables and 1 dependent variable.
The measurement levels of these variables are as follows:
a. Dependent variable: Time spent in the emergency department.
b. Independent variable: Age, Admitted, Triage and Gender.
Observations:
SPSS will produce different tables as output for the regression performed.
Let us analyse the model summary table.
Test for normality:

Figure: Histogram with Normal Curve

From the above curve, it is clearly understood that the data is normally distributed as
it forms a bell-shaped curve with its mean, median and mode lies at the centre.

12 | P a g e
 Figure: P-P Plot

As there is significant deviation between the Observed cumulative Probability and

Time spent in emergency department (Hours), we can infer that the data is likely to be
uniform (flat).

Figure: Scatter Plot

In the above scatter plot, the data is not been scattered uniformly. So, we cannot see
any specific pattern here. It proves the existence of heteroscedasticity in the data of Time
spent in emergency department.

13 | P a g e
Let us look at the tables generated by SPSS for multiple linear regression.

Figure: Model Summary Table

Looking at the observation from the above table, it can be inferred that the adjusted
R square of our model is 0.103 with the R square = 0.108. This means that the linear
regression explains 10.8% of the variance in the data. The Durbin-Watson d=1.042, which is
between the range 0 < d < 2. Therefore, we can assume that there is positive
autocorrelation in our multiple linear regression data.

Figure: ANOVA

The above test represents that F (11676.231) = 19.814 and p value is less than 0.05.
Hence, it clearly depicts that given model is good fit for the data.

Figure: Coefficient Table

The values of independent variables can be used for forecasting the output variable
i.e. Time spent in Emergency department (Hours).

14 | P a g e
 With a unit increase in severity of condition and in gender, the Time spent in
emergency department (Hours) will get reduced by 1.071 and 2.852 respectively and the
value of the Time spent in emergency department (Hours) is increased by an amount based
on the regression coefficient specified against each predictor variable with a unit increase in
the value of predictor variable.
After substituting the values, in the multiple regression model, the equation looks as
follows:
Time spent in Emergency department (Hours) = 12.261 – (1.071 x Severity of
condition) – (2.852 x gender) + (20.160 x Admitted to hospital)

3.2. Limitations of Regression Model:

The regression analysis methodology faces the following serious limitations:

 It is assumed that the cause and effect relationship between the variables remains
unchanged. This assumption may not always hold good and hence estimation of the
values of a variable made on the basis of the regression equation may lead to
erroneous and misleading results (Homework1.com, 2019).
 The functional relationship that is established between any two or more variables on
the basis of some limited data may not hold good if more and more data are taken
into consideration. For example, in case of the Law of Return, the law of diminishing
return may come to play, if too much of inputs are used with ca view to increasing
the volume of output (Homework1.com, 2019).
 It involves very lengthy and complicated procedure of calculations and analysis
(Homework1.com, 2019).
 It cannot be used in case of qualitative phenomenon (Homework1.com, 2019).

3.3. Suggestion for Model Improvement:

 Add interaction terms to model how two or more independent variables together
impact the target variable.
 Add polynomial terms to model the nonlinear relationship between an independent
variable and the target variable.
 Add spines to approximate piecewise linear models.
 Fit isotonic regression to remove any assumption of the target function form.

15 | P a g e
4. Conclusions:
 Ford hospital has seen the greatest number of admissions to its emergency
department with 63.6% (315) out of 495 patients with severity level 3 and lowest is
2.6% (13) with severity level 1.
 Patients aged between 20-80 years has been visited the emergency department
most.
 Around 400 patients spent less time in the emergency department of the Ford
Hospital.
 Patients have visited almost evenly on all the weekdays to the hospital.
 Most of the patients have visited the hospital in the month of January (61.2%) and
least in March (0.8%).
 495 patients, 379 patients (76.6%) didn’t admitted to the hospital. Whereas, 116
patients (23.4%) got admitted to the hospital

16 | P a g e
  Total of 379 patients didn’t admitted and 116 admitted to the hospital after visiting
the ED, out of 495 patients.
 Almost equal amount of male and female patients has visited the ED.
 Time spent in the emergency department by males are less then compared to the
females.
 There was no significant difference on the amount of time spent by the patients in
the emergency department arriving on different days.

5. References:
Adi Bhat (2020), “Research Design: Definition, Characteristics and Types” [Online]. Available
at: https://www.questionpro.com/blog/research-design/ (Accessed on 08 Mar 2020)
Amy Gallo (2015), “A Refresher on Regression Analysis” [Online]. Available at:
https://hbr.org/2015/11/a-refresher-on-regression-analysis (Accessed on 06 Mar 2020)
Homework1.com (2019), “Limitations of Regression Analysis in Statistics” [Online]. Available
at: https://homework1.com/statistics-homework-help/limitations-of-regression-analysis/
(Accessed on 07 Mar 2020)

17 | P a g e
Laerd Statistics (2018), “Kruskal-Wallis H Test using SPSS Statistics” [Online]. Available at:
https://statistics.laerd.com/spss-tutorials/kruskal-wallis-h-test-using-spss-statistics.php
(Accessed on 07 Mar 2020)
Shodhganga.com (2020), “A Study of Information Security policies, P-58” [Online]. Available
at: https://shodhganga.inflibnet.ac.in/bitstream/10603/2026/16/16_chapter%203.pdf
(Accessed on 06 Mar 2020)
Statistics How To (2020), “ANOVA Test: Definition, Types, Examples” [Online]. Available at:
https://www.statisticshowto.datasciencecentral.com/probability-and-statistics/hypothesis-
testing/anova/ (Accessed on 07 Mar 2020)
Study.com (2020), “Chi Square: Definition & Analysis” [Online]. Available at:
https://study.com/academy/lesson/chi-square-definition-analysis.html (Accessed on 07 Mar
2020)
University of Connecticut (2020), “Educational Research Basics by Del Siegel” [Online].
Available at: https://researchbasics.education.uconn.edu/t-test/ (Accessed on 07 Mar 2020)
University of the Witwatersrand (2020), “Research Support: Research Methodology”
[Online]. Available at: https://libguides.wits.ac.za/c.php?g=693518&p=4914913 (Accessed
on 06 Mar 2020)

6. Appendix:

18 | P a g e
 Figure: Bar graph of no. of patients visited on weekdays

Figure: Bar graph of no. of patients visited in different months (Jan-Aug)

Figure: Bar graph of no. of patients admitted and not admitted to the hospital

19 | P a g e
 Figure: Bar graph of no. of male and female patients visited the hospital

Figure: Bar graph of no. of male and female patients who admitted and not admitted to the hospital

Figure: Scatter plot of Time spent in emergency department v/s Age of patient

20 | P a g e
 Figure: Scatter plot of Time spent in emergency department v/s Gender

Figure: Scatter plot of Time spent in emergency department v/s Severity of Condition

Figure: Scatter plot of Time spent in emergency department v/s Admitted to Hospital

21 | P a g e
22 | P a g e