Burden of delayed discharge on acute hospital medical wards: A retrospective ecological study in Rome, Italy.
In: PLoS ONE, Jg. 19 (2024-01-24), Heft 1, S. 1-18
Online
academicJournal
Zugriff:
Introduction: Delayed discharge represents the difficulty in proceeding with discharge of patients who do not have any further benefit from prolonged stay. A quota of this problem is related to organizational issues. In the Lazio region in Italy, a macro service re-organization in on the way, with a network of hospital and territorial centers engaged in structuring in- and out- of hospital patient pathways, with a special focus on intermediate care structures. Purpose of this study is to quantify the burden of delayed discharge on a single hospital structure, in order to estimate costs and occurrence of potential resource misplacement. Material and methods: Observational Retrospective study conducted at the Santo Spirito Hospital in Rome, Italy. Observation period ranged from 1/09/2022, when the local database was instituted, to 1/03/2023 (6 months). Data from admissions records was anonymously collected. Data linkage with administrative local hospital database was performed in order to identify the date a discharge request was fired for each admission. Surgical discharges and Intensive Care Unit (ICU) discharges were excluded from this study. A Poisson hierarchical regression model was employed to investigate for the role of ward, Severity of Disease (SoD) and Risk of Mortality (RoM) on elongation of discharge time. Results: 1222 medical ward admissions were recorded in the timeframe. 16% of them were considered as subject to potentially elongated stay, and a mean Delay in discharge of 6.3 days (SD 7.9) was observed. Discussion and conclusions: Delayed discharge may cause a "bottleneck" in admissions and result in overcrowded Emergency Department, overall poor performance, and increase in overall costs. A consisted proportion of available beds can get inappropriately occupied, and this inflates both direct and indirect costs. Clinical conditions on admission are not a good predictor of delay in discharge, and the root causes of this phenomenon likely lie in organizational issues (on structure\system level) and social issues (on patient's level). [ABSTRACT FROM AUTHOR]
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Burden of delayed discharge on acute hospital medical wards: A retrospective ecological study in Rome, Italy.
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Autor/in / Beteiligte Person: | Vinci, Antonio ; Furia, Giuseppe ; Cammalleri, Vittoria ; Colamesta, Vittoria ; Chierchini, Patrizia ; Corrado, Ornella ; Mammarella, Assunta ; Ingravalle, Fabio ; Bardhi, Dorian ; Malerba, Rosa Maria ; Carnevale, Edoardo ; Gentili, Susanna ; Damiani, Gianfranco ; De Vito, Corrado ; Maurici, Massimo |
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Zeitschrift: | PLoS ONE, Jg. 19 (2024-01-24), Heft 1, S. 1-18 |
Veröffentlichung: | 2024 |
Medientyp: | academicJournal |
ISSN: | 1932-6203 (print) |
DOI: | 10.1371/journal.pone.0294785 |
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