Discharge Delays for Patients Requiring In-Hospital Guardianship: A Cohort Analysis

Discharge Delays for Patients Requiring In-Hospital Guardianship: A Cohort Analysis

To assess nonclinical factors delaying hospital discharge of guardianship patients. Utilization review data over 3 years. Retrospective cohort study. Mann-Whitney test was used to compare patients' medically unnecessary days (MUD) of hospitalization with additional subcategories of delays-defin...

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Bibliographic Details
Published in:Journal for healthcare quality Vol. 38; no. 4; pp. 235 - 242
Main Authors: Chen, Jasper J, Finn, Christine T, Homa, Karen, St Onge, Kenneth P, Caller, Tracie A
Format: Journal Article
Language:English
Published: United States 01-07-2016
Subjects:
Adult
Aged
Aged, 80 and over
Canada
Female
Health administration
Hospitalization
Humans
Legal Guardians
Length of Stay
Male
Middle Aged
Patient Discharge
Retrospective Studies
Statistics, Nonparametric
Time Factors
United States
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Summary:To assess nonclinical factors delaying hospital discharge of guardianship patients. Utilization review data over 3 years. Retrospective cohort study. Mann-Whitney test was used to compare patients' medically unnecessary days (MUD) of hospitalization with additional subcategories of delays-defined as beyond clinicians' control. Overall median number of MUD was 19.5; 14 of 48 patients were additionally delayed while awaiting long-term care Medicaid approval (N = 7, 50%), pending insurance (N = 3, 21%), social or transportation difficulties (N = 3, 21%), or preadmission review (N = 1, 7%). The median number of MUD for the 14 delayed patients was 63, a difference of 53 days compared with the routine guardianship cohort (P < .0001) and $5.5M in net revenue opportunity. Nonclinical discharge delays for guardianship patients are costly and potentially unavoidable. Further exploration into policy change is therefore recommended.
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ISSN:1062-2551
1945-1474
DOI:10.1097/01.JHQ.0000462680.47759.53