Delayed Hospital Discharges of Older Patients: A Systematic Review on Prevalence and Costs

Landeiro, Filipa; Roberts, Kenny; Gray, Alastair; Leal, José

doi:10.1093/geront/gnx028

Cited by 62 publications

(77 citation statements)

References 70 publications

(17 reference statements)

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“…A third element of ADH is unnecessarily long hospital stays, when inpatients deemed medically fit for discharge continue to occupy a hospital bed for nonclinical reasons. The mean cost of a single case of delayed hospital discharge has been estimated at USD 7,020 by a systematic international review 23 .…”

Section: Figurementioning

confidence: 99%

Meeting the complex challenge of health and social care provision for rapidly-ageing populations: introducing the concept of “avoidable displacement from home”

et al. 2020

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The increasing numbers of people at very old ages pose specific policy challenges for health and social care and highlight the need to rethink established models of service provision. The main objective of this paper is to introduce the concept of “avoidable displacement from home” (ADH). The study argues that ADH builds on and adds value to existing concepts, offering a holistic, person-centered framework for integrated health and social care provision for older people. It also demonstrates that this framework can be applied across different levels, ranging from macro policymaking to organizational and individual decision-making. The paper pays attention to the Brazilian context but argues that ADH is a universally applicable concept.

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Section: Figurementioning

confidence: 99%

Meeting the complex challenge of health and social care provision for rapidly-ageing populations: introducing the concept of “avoidable displacement from home”

et al. 2020

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“…Delayed hospital discharges and inappropriate placement of patients in acute care have been studied in a number of countries [18]. At a system level there are a number of possible solutions, including regional coordination, monitoring and care pathways that have been used to address this issue [6] (Hiltunen, et al, 2020).…”

Section: Implementation Of Pine Villamentioning

confidence: 99%

Improving the Use of Healthcare Resources in Canadian Hospitals: The Impact of a Reintegration Unit in Expanding Acute Care Capacity and Resource Use in Sunnybrook Health Sciences Centre

Cheng¹,

Baker²,

Carew³

et al. 2020

Preprint

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Background: Alternate level of care (ALC) patients are those who reside in acute hospital beds but can be managed in non-hospital settings. They contribute to high occupancy levels in Canadian hospitals. Between 2017-18, Ontario spent 1.1 billion dollars on hospitalized patients waiting for alternate level of care (ALC) beds. To improve value for care, Ontario Ministry of Health (MOHLTC) invested into reintegration units which are designed to transfer ALC patients out of hospital and transition them back into the community or long-term care (LTC). Given today’s healthcare budget pressures, it is unclear if reactivation units are feasible. In 2018, the MOHLTC funded a reintegration unit, Pine Villa with an operational partner, Sunnybrook Hospital and community service providers (SPRINT Senior Care, LOFT) in Toronto, Ontario. The objective was to determine averted costs for ALC-patients and impact on Sunnybrook patient flow-through if ALC-patient Pine Villa transfers occurred on the day of ALC readiness. Methods: Retrospective, observational analysis of Sunnybrook ALC-patients discharged to Pine Villa between January 9, 2018 to February 4, 2019. From the healthcare payer’s perspective (MOHTLC), cost analysis was modelled for ALC patients designated for 1) LTC and 2) home with supports. Avoided costs at time of ALC readiness were determined by case-costing. Averted hospital ALC days were established. Results: If ALC patients were transferred to Pine Villa at time of ALC readiness for LTC, the healthcare system could have averted 5.4 million dollars from Sunnybrook. If the patients were transferred for home, 2.3 million dollars could have been averted. Both models increased acute Sunnybrook Hospital capacity by 34 beds. Conclusion: There is a business case supporting reintegration units if ALC-patients are discharged from the hospital on the day of ALC-readiness.

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“…For care transitions, these two quality outcomes are highly inter-related. Canada and other commonwealth countries have given a lot of attention to examining the prevalence and cause of hospital stays that extend beyond medical need (CIHI, 2012;Landeiro, Roberts, Gray & Leal, 2017;Salonga-Reyes & Scott, 2017), as a delayed or slow discharge from hospital to home is considered costly to the health system (Fransoo et al, 2013;Landeiro et al, 2017). Arguably more importantly, long lengths of stay are associated with greater functional decline for older adults at the time of discharge (Zisberg, Shadmi, Gur-Yaish, Tonkikh & Sinoff, 2015).…”

Section: Timeliness/efficiencymentioning

confidence: 99%

Health, Social, and Functional Characteristics of Older Adults With Continuing Care Needs: Implications for Integrated Care

Brown

Menec

2018

J Aging Health

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Delayed Hospital Discharges of Older Patients: A Systematic Review on Prevalence and Costs

Cited by 62 publications

References 70 publications

Meeting the complex challenge of health and social care provision for rapidly-ageing populations: introducing the concept of “avoidable displacement from home”

Meeting the complex challenge of health and social care provision for rapidly-ageing populations: introducing the concept of “avoidable displacement from home”

Improving the Use of Healthcare Resources in Canadian Hospitals: The Impact of a Reintegration Unit in Expanding Acute Care Capacity and Resource Use in Sunnybrook Health Sciences Centre

Health, Social, and Functional Characteristics of Older Adults With Continuing Care Needs: Implications for Integrated Care

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