CLAHRC BITE: Impact of delayed discharge from hospital

North ThamesGeneric Health Relevance
Published Date: 20 Apr 2018

 

Impact of delayed discharge from hospital

 

Background

Delayed discharge—de ned as ‘the period of con nued hospital stay a er a pa ent is deemed medically t to leave hospital but is unable to do so for non-medical reasons’— is an important problem for health-care providers interna onally. Costs to the Na onal Health Service (NHS) in England associated with delayed discharge are approximately £100m per year.

Delayed discharge is recognized to be a system-level problem requiring e ec ve team working within hospitals and coordina on between health and social care.

However, an in-depth understanding of the impact of delayed discharge on pa ents and the health-care sta caring for them needs to be established so that managers and policymakers can make informed decisions about addressing the consequences of delays.

The costs ( nancial and other) of delayed discharge to hospitals, the health and social care system, and pa ents and carers also need to be understood.

We carried out a mixed-studies systema c

review to assess the impact and experiences of delayed discharge at mul ple levels, from the perspec ve of pa ents, health professionals and

hospitals; and associated costs of delay.

 

What we did

Our review included studies wri en in English, published since 2000 and conducted in OECD countries, to examine delayed discharge across health systems in countries with comparable economic development. We examined quan ta ve and qualita ve studies to:

  1. i)  quan fy the impact of delayed discharge on health outcomes

  2. ii)  qualita vely assess impacts on pa ents, health professionals and provider organiza ons

  3. iii)  evaluate the poten al costs associated with delay.

Studies were included where they met one or more of the following inclusion criteria:

  1. i)  quan ta ve data on the impact of delayed discharge on health outcomes (egg quality of care, pa ent sa sfac on, number of infec ons, mental health, mortality, morbidity, readmissions and func oning),

  2. ii)  qualita ve data on experiences of delay from perspec ves of pa ents (egg perceived impact on physical health or pa ent experience), health professionals (e.g. a ect on sta role and working rela onships) and hospitals (impacts at the organiza onal level, e.g. costs of managing delays and a ect on culture), and/or

  3. iii)  informa on on costs of delay due to unnecessary bed-days.