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...
Autores principales: | , , , , |
---|---|
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 |