Delay in hospital discharge of trauma patients in a University Hospital in Egypt: A prospective observational study
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Author
El-Abbassy, IslamMohamed, Wafaa
El-Hariri, Hazem Mohamed
El-Setouhy, Maged
Hirshon, Jon Mark
El-Shinawi, Mohamed
Date
2021-10-28Journal
African journal of Emergency MedicinePublisher
Elsevier BVType
Article
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Introduction: "Delayed discharge" is defined as patients who remain hospitalised beyond the time of being fit for discharge after a decision of discharge has been made by the managing team. There is no standardised amount of time defining delayed discharge documented in the literature, and there is a lack of evidence about this topic in Egypt. This study is a quality improvement project aiming to identify the factors associated with discharge delays at a single centre in Egypt in order to address this issue. Methods: A prospective observational study included all trauma patients admitted to a University Hospital in Egypt over two months. The time of the decision of discharge and actual discharge time were recorded by reviewing patients' medical records. The patients and their caregivers were asked to fill in a questionnaire about the reasons for delayed discharge. Potential reasons for the delayed discharge were classified into system-related, medical and family-related factors. Results: The study included 498 patients with a median age of 41 years (9-72). The median time from discharge decision until actual discharge was 3 h. System-related factors were documented in 48.8% of cases, followed by medical factors (36.3%), and family-related factors (28.1%). When controlling for age, gender and injury severity score using a logistic regression analysis, longer time to discharge (≥3 h) showed a stronger association with medical factors [adjusted OR (95% CI) = 5.44 (2.73-10.85)] and family-related factors [adjusted OR (95% CI) = 7.94 (3.40-18.54)] compared to system-related factors [adjusted OR (95% CI) = 2.20 (1.12-4.29)]. Discussion: Although system-related factors were more prevalent, medical and family-related factors appear to be associated with longer discharge delays compared to system-related factors.Sponsors
Fogarty International CenterRights/Terms
© 2018 Published by Elsevier Ltd. CC BY 4.0Keyword
Delayed dischargeSystem-related factors
Family-related factors
Medical factors
Time to discharge
Identifier to cite or link to this item
http://hdl.handle.net/10713/17122ae974a485f413a2113503eed53cd6c53
10.1016/j.afjem.2021.06.008