Cargando…

Barriers to Discharge in Geriatric Long Staying Inpatient and Emergency Department Admissions: A Descriptive Study

Background: This study describes long length of stay during emergency department (ED) visits and hospital admissions, barriers to discharge, and discharge solutions for geriatric patients. Methods: We conducted a retrospective medical record review of a random sample of 150 ED patients and 150 inpat...

Descripción completa

Detalles Bibliográficos
Autores principales: Keverline, Kelsey J., Mow, Steve J., Cyr, Julianne Maire, Platts-Mills, Timothy, Brice, Jane H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8396028/
https://www.ncbi.nlm.nih.gov/pubmed/34449655
http://dx.doi.org/10.3390/geriatrics6030078
_version_ 1783744296505049088
author Keverline, Kelsey J.
Mow, Steve J.
Cyr, Julianne Maire
Platts-Mills, Timothy
Brice, Jane H.
author_facet Keverline, Kelsey J.
Mow, Steve J.
Cyr, Julianne Maire
Platts-Mills, Timothy
Brice, Jane H.
author_sort Keverline, Kelsey J.
collection PubMed
description Background: This study describes long length of stay during emergency department (ED) visits and hospital admissions, barriers to discharge, and discharge solutions for geriatric patients. Methods: We conducted a retrospective medical record review of a random sample of 150 ED patients and 150 inpatients with long length of stay (LOS) encounters. Cohorts were characterized by demographics, social determinants of health (e.g., health insurance, housing), medical comorbidities at admission, discharge care coordination, and final disposition. Results: In the ED, the primary barrier to discharge was inadequate inpatient bed availability (63%). In the inpatient setting, barriers to discharge were predominantly due to a demonstrated medical requirement for continued hospitalization (55%), followed by difficulty with coordinating discharge to a skilled nursing facility or rehabilitation center (22%). Discussion: Among long LOS ED patients, discharge delays were often the result of unavailable inpatient beds and services. Reducing the LOS for ED patients may require further investigation as to which hospital services are most frequently utilized by geriatric patients and structuring inpatient bed allocation to prevent extended patient boarding in the ED. Reducing long inpatient LOS may require early identification of high-risk patients and strengthening of relationships with community-based services.
format Online
Article
Text
id pubmed-8396028
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-83960282021-08-28 Barriers to Discharge in Geriatric Long Staying Inpatient and Emergency Department Admissions: A Descriptive Study Keverline, Kelsey J. Mow, Steve J. Cyr, Julianne Maire Platts-Mills, Timothy Brice, Jane H. Geriatrics (Basel) Article Background: This study describes long length of stay during emergency department (ED) visits and hospital admissions, barriers to discharge, and discharge solutions for geriatric patients. Methods: We conducted a retrospective medical record review of a random sample of 150 ED patients and 150 inpatients with long length of stay (LOS) encounters. Cohorts were characterized by demographics, social determinants of health (e.g., health insurance, housing), medical comorbidities at admission, discharge care coordination, and final disposition. Results: In the ED, the primary barrier to discharge was inadequate inpatient bed availability (63%). In the inpatient setting, barriers to discharge were predominantly due to a demonstrated medical requirement for continued hospitalization (55%), followed by difficulty with coordinating discharge to a skilled nursing facility or rehabilitation center (22%). Discussion: Among long LOS ED patients, discharge delays were often the result of unavailable inpatient beds and services. Reducing the LOS for ED patients may require further investigation as to which hospital services are most frequently utilized by geriatric patients and structuring inpatient bed allocation to prevent extended patient boarding in the ED. Reducing long inpatient LOS may require early identification of high-risk patients and strengthening of relationships with community-based services. MDPI 2021-08-11 /pmc/articles/PMC8396028/ /pubmed/34449655 http://dx.doi.org/10.3390/geriatrics6030078 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Keverline, Kelsey J.
Mow, Steve J.
Cyr, Julianne Maire
Platts-Mills, Timothy
Brice, Jane H.
Barriers to Discharge in Geriatric Long Staying Inpatient and Emergency Department Admissions: A Descriptive Study
title Barriers to Discharge in Geriatric Long Staying Inpatient and Emergency Department Admissions: A Descriptive Study
title_full Barriers to Discharge in Geriatric Long Staying Inpatient and Emergency Department Admissions: A Descriptive Study
title_fullStr Barriers to Discharge in Geriatric Long Staying Inpatient and Emergency Department Admissions: A Descriptive Study
title_full_unstemmed Barriers to Discharge in Geriatric Long Staying Inpatient and Emergency Department Admissions: A Descriptive Study
title_short Barriers to Discharge in Geriatric Long Staying Inpatient and Emergency Department Admissions: A Descriptive Study
title_sort barriers to discharge in geriatric long staying inpatient and emergency department admissions: a descriptive study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8396028/
https://www.ncbi.nlm.nih.gov/pubmed/34449655
http://dx.doi.org/10.3390/geriatrics6030078
work_keys_str_mv AT keverlinekelseyj barrierstodischargeingeriatriclongstayinginpatientandemergencydepartmentadmissionsadescriptivestudy
AT mowstevej barrierstodischargeingeriatriclongstayinginpatientandemergencydepartmentadmissionsadescriptivestudy
AT cyrjuliannemaire barrierstodischargeingeriatriclongstayinginpatientandemergencydepartmentadmissionsadescriptivestudy
AT plattsmillstimothy barrierstodischargeingeriatriclongstayinginpatientandemergencydepartmentadmissionsadescriptivestudy
AT bricejaneh barrierstodischargeingeriatriclongstayinginpatientandemergencydepartmentadmissionsadescriptivestudy