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Published on: September 30, 2020
Discharge Delays for Patients Requiring In-Hospital Guardianship: A Cohort Analysis
Objective:
To assess nonclinical factors delaying hospital discharge of guardianship patients.
Data:
Utilization review data over 3 years.
Design:
Retrospective cohort study.
Analysis:
Mann-Whitney test was used to compare patients' medically unnecessary days (MUD) of hospitalization with additional subcategories of delays-defined as beyond clinicians' control.
Findings:
Overall median number of MUD was 19.5; 14 of 48 patients were additionally delayed while awaiting long-term care Medicaid approval (N = 7, 50%), pending insurance (N = 3, 21%), social or transportation difficulties (N = 3, 21%), or preadmission review (N = 1, 7%). The median number of MUD for the 14 delayed patients was 63, a difference of 53 days compared with the routine guardianship cohort (P < .0001) and $5.5M in net revenue opportunity.
Conclusions:
Nonclinical discharge delays for guardianship patients are costly and potentially unavoidable. Further exploration into policy change is therefore recommended.
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