TY - JOUR
T1 - Reasons for delayed discharge of trauma patients
AU - Brasel, Karen J.
AU - Rasmussen, Jason
AU - Cauley, Charline
AU - Weigelt, John A.
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2002
Y1 - 2002
N2 - Background. In the trauma population, increased length of stay is associated with age, comorbidities, and injury severity. We hypothesized that a significant contributor to a delay in length of stay was unrelated to these variables. Materials and methods. All trauma patients admitted for > 48 h with acute injury from 7/1/2000 to 9/30/2000 were evaluated daily for discharge readiness. Actual discharge time was recorded from the time discharge orders were written. A discharge-ready patient not discharged within 24 h was a Delay discharge. Discharge delay was categorized as availability of rehabilitation beds, family reasons, or system-related delay. Payer was classified as commercial, government, Medicare, or uninsured. Actual hospital costs were used. Results. One hundred twenty-eight patients were evaluated; 30 patients had a delay in discharge. The average delay was 2 days (range 1-15 days). Mean hospital stay for Delay patients was 13.4 days, and 8.1 days for Timely patients (P < 0.05). Injury severity, age, and comorbidities were not different among groups. The main reason for delay was lack of a rehabilitation bed. Hospital costs were $39, 013 per patient in the Delay group and $24, 414 in the Timely group. Delay patients were more likely to be uninsured, have an orthopedic injury, and require ICU care. Conclusion. Discharge delays significantly lengthen hospital stay for nonmedical reasons in trauma patients. Improved efficiency in a trauma system will require changes from acute care to rehabilitation.
AB - Background. In the trauma population, increased length of stay is associated with age, comorbidities, and injury severity. We hypothesized that a significant contributor to a delay in length of stay was unrelated to these variables. Materials and methods. All trauma patients admitted for > 48 h with acute injury from 7/1/2000 to 9/30/2000 were evaluated daily for discharge readiness. Actual discharge time was recorded from the time discharge orders were written. A discharge-ready patient not discharged within 24 h was a Delay discharge. Discharge delay was categorized as availability of rehabilitation beds, family reasons, or system-related delay. Payer was classified as commercial, government, Medicare, or uninsured. Actual hospital costs were used. Results. One hundred twenty-eight patients were evaluated; 30 patients had a delay in discharge. The average delay was 2 days (range 1-15 days). Mean hospital stay for Delay patients was 13.4 days, and 8.1 days for Timely patients (P < 0.05). Injury severity, age, and comorbidities were not different among groups. The main reason for delay was lack of a rehabilitation bed. Hospital costs were $39, 013 per patient in the Delay group and $24, 414 in the Timely group. Delay patients were more likely to be uninsured, have an orthopedic injury, and require ICU care. Conclusion. Discharge delays significantly lengthen hospital stay for nonmedical reasons in trauma patients. Improved efficiency in a trauma system will require changes from acute care to rehabilitation.
KW - Discharge
KW - Injury severity
KW - Insurance
KW - Length of stay
KW - Outcomes
KW - Trauma
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U2 - 10.1006/jsre.2002.6512
DO - 10.1006/jsre.2002.6512
M3 - Article
C2 - 12429179
AN - SCOPUS:0036434633
SN - 0022-4804
VL - 107
SP - 223
EP - 226
JO - Journal of Surgical Research
JF - Journal of Surgical Research
IS - 2
ER -