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Delays in discharge in a tertiary care pediatric hospital

Rajendu Srivastava1, Bryan L Stone, Raza Patel

  • 1Division of Inpatient Medicine, Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, Utah 84113, USA. raj.srivastava@hsc.utah.edu

Journal of Hospital Medicine
|October 14, 2009
PubMed

Insights

Hospital discharge delays impact care efficiency and costs. Nearly a quarter of patients experienced delays, contributing to extended length of stay (LOS) and significant financial costs.

Area of Science:

  • Pediatric hospital medicine
  • Healthcare quality improvement
  • Health services research

Background:

  • Delays in hospital discharges negatively affect patient care efficiency and timeliness.
  • Discharge delays are a critical indicator of inpatient care quality.

Purpose of the Study:

  • To quantify the number, duration, and types of delays in hospital discharges.
  • To assess the impact of these delays on overall length of stay (LOS) and associated costs.

Main Methods:

  • A prospective observational cohort study was conducted at a tertiary-care children's hospital.
  • Data were collected from 171 children across two medical teams over one month.
  • The Delay Tool was used to classify delays, with LOS and costs extracted from administrative data.

Main Results:

  • 22.8% of patients experienced at least one delay, contributing to 82 extra hospital days (9% of total) and $170,000 in costs (8.9% of total).
  • The primary causes of delays were physician behavior (42.3%), discharge planning (21.8%), consultations (14.1%), and test scheduling (12.8%).
  • Mean LOS was 7.3 days and mean costs were $15,197.

Conclusions:

  • A significant proportion of pediatric patients could have been discharged earlier, highlighting substantial impacts on LOS and healthcare expenditures.
  • Interventions should focus on standardizing physician discharge criteria, optimizing discharge planning processes, and improving the timeliness of consultations and diagnostic testing.
Abstract

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