Discharge Delays for Patients Requiring In-Hospital Guardianship
| Autor: | Kenneth P. St. Onge, Tracie A. Caller, Jasper J. Chen, Karen Homa, Christine T. Finn |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Canada medicine.medical_specialty Time Factors MEDLINE Utilization review Statistics Nonparametric 03 medical and health sciences Legal Guardians 0302 clinical medicine Legal guardian Hospital discharge medicine Humans 030212 general & internal medicine Aged Retrospective Studies Aged 80 and over business.industry 030503 health policy & services Health Policy Public Health Environmental and Occupational Health Retrospective cohort study Length of Stay Middle Aged Patient Discharge United States Hospitalization Emergency medicine Cohort Female 0305 other medical science business Medicaid Cohort study |
| Zdroj: | Journal for Healthcare Quality. 38:235-242 |
| ISSN: | 1062-2551 |
| Popis: | OBJECTIVE To assess nonclinical factors delaying hospital discharge of guardianship patients. DATA Utilization review data over 3 years. DESIGN Retrospective cohort study. ANALYSIS Mann-Whitney test was used to compare patients' medically unnecessary days (MUD) of hospitalization with additional subcategories of delays-defined as beyond clinicians' control. FINDINGS 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. CONCLUSIONS Nonclinical discharge delays for guardianship patients are costly and potentially unavoidable. Further exploration into policy change is therefore recommended. |
| Databáze: | OpenAIRE |
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