SHM Converge Scientific Abstract ePoster Gallery-Prevalence of Delayed Discharge From the Hospital in a National Cohort of Older Adults

Pdf Summary

This study examined delayed hospital discharges among older Veterans in the Veterans Health Administration (VHA), using national utilization management data from 2018–2022. The key question was how often hospitalized patients were ready to leave by clinical criteria but were still not discharged, and why.<br /><br />The study included 777,000 Veterans age 65 and older and 7.8 million hospital days across VHA hospitals. Utilization management nurses reviewed inpatients daily to determine whether they still “met criteria” to remain hospitalized. If a patient did not meet criteria but remained in the hospital, that day was counted as a delayed discharge.<br /><br />Main findings: delayed discharge was very common. About 55.5% of older Veterans experienced at least one delayed discharge, and these delays accounted for 40% of all hospital days. Among 3.13 million inpatient days where patients did not meet criteria to stay, the most common reason was clinical instability or lack of medical necessity (24%). Other major reasons included delays in post-acute transitions (10%), care that could have been delivered outpatient (5%), social barriers (3%), no bed available at the recommended level of care (2%), and adverse conditions such as court- or CMS-related issues (1.5%).<br /><br />The study also tracked trends over time from 2018 to 2022, showing the burden of delayed discharge remained substantial throughout the period.<br /><br />Overall, the findings provide the first nationally representative estimate of delayed discharge in the VHA and suggest that prolonged hospital stays are widespread, often driven by system-level and transition-of-care barriers rather than ongoing acute medical need.

Asset Subtitle

Robert E. Burke

Meta Tag

Author List Aditi Desai, Ann Tierney, Jacqueline M. Ferguson, Robert E. Burke

Category Research

Concept Hospital Discharge Delay

Concept Utilization Management Review

Concept Older Veterans

Concept Veterans Health Administration Hospitals

Concept Hospitalization Criteria

Distinguished Finalist

Presenter Organization University of Pennsylvania

Presenting Author Robert E. Burke

Track Value in Hospital Medicine

Keywords

delayed discharge

Veterans Health Administration

older Veterans

hospital utilization

inpatient days

medical necessity

post-acute transitions

care transitions

hospital length of stay

system-level barriers

Hospital Discharge Delay

Utilization Management Review

Older Veterans

Veterans Health Administration Hospitals

Hospitalization Criteria