SHM Converge Scientific Abstract ePoster Gallery-Prolonged Discharge Delays Across Us Hospitals: Prevalence, Cause, and Impact

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This cross-sectional study examined how often hospitalized patients on general medicine services were medically ready for discharge but remained in the hospital for at least one week. Data were collected on a single day in August 2022 from 15 U.S. academic hospitals using physician-reported patient lists.<br /><br />Among 1,928 sampled patients, 189 (9.8%) had been medically ready for discharge for one week or longer. This phenomenon was present in nearly all participating hospitals and accounted for a substantial share of hospital days: between 20.7% and 40.2% of all hospital days at the sampled sites were spent by patients who were medically ready but still awaiting discharge.<br /><br />Most of these patients had unmet post-acute or support needs. Specifically, 85% were waiting for discharge resources outside hospital control, 86% needed support such as skilled therapy, activities of daily living (ADLs), or instrumental ADLs, and 32% were admitted for limited medical acuity, such as placement needs. The most common expected discharge destinations were skilled nursing facilities (39%), home/apartment (21%), group homes (14%), and medical respite (10%).<br /><br />The burden was greater in certain hospital types, including public hospitals, county hospitals, and safety-net hospitals, suggesting inequities in access to discharge resources and post-acute care. The authors conclude that delayed discharge is a common and consequential issue affecting vulnerable patients and contributing meaningfully to hospital capacity strain. Future work should focus on identifying barriers to discharge and improving equitable access to needed support services.

Asset Subtitle

Maralyssa Bann

Meta Tag

Author List Amy Ou, JP Lopez, Maralyssa Bann, Molly Rosenthal, Nicholas Meo, Paul Helgerson

Category Research

Concept Hospital Length of Stay

Concept Discharge Delay

Concept Medical Readiness for Discharge

Concept Patient Safety

Concept Cross-Sectional Study

Distinguished Non-Finalist

Presenter Organization Harborview Medical Center-University of Washington

Presenting Author Maralyssa Bann

Track Transitions of Care

Keywords

delayed discharge

hospitalized patients

medical readiness

general medicine

post-acute care

discharge barriers

hospital capacity

safety-net hospitals

skilled nursing facilities

equity in care

Hospital Length of Stay

Discharge Delay

Medical Readiness for Discharge

Patient Safety

Cross-Sectional Study