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Identifying Key Predictors of Appropriate Discharge Destinations for Older Inpatients in Acute Care: Scoping Review
Christoph Leinert1, Marina Liselotte Fotteler1,2, Thomas Derya Kocar1
1Institute for Geriatric Research at Agaplesion Bethesda Ulm, Ulm University Medical Center, Zollernring 26, Ulm, 89073, Germany, 49 07311870.
Interactive Journal of Medical Research
|January 22, 2026
Summary
Identifying predictors for appropriate postacute care (PAC) destinations is crucial for geriatric inpatients. This review highlights key factors like age, cognitive status, and functional abilities to guide discharge decisions for older adults.
Area of Science:
- Geriatric Medicine
- Health Services Research
- Clinical Informatics
Background:
- Postacute care (PAC) services are vital for functional recovery in geriatric inpatients.
- Choosing the most suitable PAC setting can be complex for healthcare providers.
- Predictors for optimal discharge destinations are needed to guide clinical decisions.
Purpose of the Study:
- To conduct a scoping review identifying predictors for appropriate discharge destinations for older adults (≥65 years) transitioning from acute care to PAC settings.
- To extract relevant predictors for various PAC settings and identify a generalizable set of predictor domains.
- To inform the development of clinical decision support systems for geriatric discharge planning.
Main Methods:
- Systematic search of multiple databases (Medline, Embase, Cochrane, PsycINFO, CINAHL, Emcare) for English/German literature up to February 2022.
- Screening, data extraction, and categorization of 171 quantitative and 10 qualitative studies by 3 researchers.
- Analysis focused on positive predictors, calculating the Jaccard index to compare domain combinations.
Main Results:
- 1047 predictors were identified across various discharge destinations, including nursing homes, skilled nursing facilities, and inpatient rehabilitation.
- Age was the most frequent positive predictor (11%).
- Key predictors varied by destination: dementia and ADL deficits for nursing homes; longer LOS and cardiopulmonary disease for rehabilitation; good ADL and mobility for home discharge.
Conclusions:
- This scoping review offers a comprehensive overview of predictors for appropriate discharge decisions in older adults.
- Identified predictor domains include cognitive impairment, ADL, demographics, social support, hospitalization data, multimorbidity, mobility, and primary diagnosis.
- Findings can inform the selection of features for clinical decision support systems and machine learning algorithms in geriatric care.
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