[Waiting time for hospital patients ready for discharge]

Patients expect to be discharged as soon as assessments and necessary treatments are completed and good clinical practice requires hospitals to manage this. To stimulate a good patient flow between hospitals and primary care institutions, the state requires primary health care institutions to pay a daily fee if they do not receive patients within one week after they have been declared ready for discharge from somatic departments. Patients from geropsychiatric departments in Oslo were included in the payment system in the period 1993-2001. The present study compares the waiting time for dischargeable patients from somatic and geropsychiatric departments in Oslo.

Waiting days from the day the patient was declared ready for discharge from somatic- and geropsychiatric departments until local government authorities were able to place the patient in a primary care institution were recorded for the period 1999-2004. The application procedures were identical and stabile for both groups through the 6-year period.

The waiting time for somatic patients decreased from 16.2 to 7.6 days during the 6-yr period, and for geropsychiatric patients it decreased from 52.0 to 32.2 days. After the payment system was stopped for geropsychiatric patients in 2002 the waiting time increased to 59.1 days for this group. In 2004, the waiting time for patients ready for discharge from a somatic department was one week, while patients from a geropsychiatric department waited for more than eight weeks.

The state induced payment system seems to reduce the waiting time for patients in both somatic- and geropsychiatric departments. After the payment system was stopped for patients in geropsychiatric departments the waiting time has increased for this group.