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    Delay in hospital discharge of trauma patients in a University Hospital in Egypt: A prospective observational study

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    Author
    El-Abbassy, Islam
    Mohamed, Wafaa
    El-Hariri, Hazem Mohamed
    El-Setouhy, Maged
    Hirshon, Jon Mark
    El-Shinawi, Mohamed
    Date
    2021-10-28
    Journal
    African journal of Emergency Medicine
    Publisher
    Elsevier BV
    Type
    Article
    
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    See at
    https://doi.org/10.1016/j.afjem.2021.06.008
    Abstract
    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 Center
    Rights/Terms
    © 2018 Published by Elsevier Ltd. CC BY 4.0
    Keyword
    Delayed discharge
    System-related factors
    Family-related factors
    Medical factors
    Time to discharge
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/17122
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.afjem.2021.06.008
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