Major discharge barriers present for one in 10 hospitalized patients

One in 10 hospitalized patients are medically ready for discharge but experience major discharge barriers, according to a study published online Aug. 8 in the Journal of Hospital Medicine.

Maralyssa Bann, M.D., from the University of Washington in Seattle, and colleagues measured the prevalence, impact, and context of patients who remain hospitalized for prolonged periods after acute care needs are met in a point-in-time survey. The analysis included structured attending physician-led survey data for 1,928 adult patients at 15 U.S. academic hospitals in the fall of 2022.

The researchers found that 35.0 percent of patients were medically ready for discharge, including 9.8 percent with major discharge barriers. Among patients with major discharge barriers, 44.4 percent had spent a month or longer medically ready for discharge. Most (84.1 percent) required some form of skilled therapy or daily living support services for discharge. Patients experiencing major discharge barriers were more commonly found in public versus private, nonprofit hospitals (12.0 versus 7.2 percent; P = 0.001) and county versus noncounty hospitals (14.5 versus 8.8 percent; P = 0.002).

"Initiatives should emphasize development of community or payer-funded transitional care programs, targeted financial and structural changes that focus on the medically complex population, as well as strategic partnerships to remove bureaucratic, administrative, and legal delays," the authors write.

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