Factors Associated with Delayed Hospital Discharge among Patients being Transferred to Home Health Care Unit

Main Article Content

Phatcharakoraphot Sreeprasarn
Nitchatima Sereewichayasawad
Nareemarn Neelapaichit

Abstract

Delayed hospital discharge is a critical issue in health care services affecting ineffective bed management and cost escalation. This cross-sectional survey research determined factors associated with delayed discharges among patients being transferred to the home health care unit. The samples consisted of 231 in-patients having the score on the Modified Barthel Index(MBI)≤ 19 andtheircaregivers(n = 231). The research
instruments included the demographic questionnaires of patients and caregivers, the MBI, the Caregiver Confidence Scale, the Family APGAR Questionnaire, and the Healthcare Professional Support Questionnaire. Data were analyzed using descriptive statistics and binary logistic regression analysis. The results revealed that the following factors had significant correlations to delayed discharge: length of hospital stay, length
of stay in the intensive care unit, prolonged respiratory problems, older age of caregivers,insufficient income,unhealthy caregivers, inexperienced caregivers, low confidence of caregivers, low family support, and limited time of discharge planning. Therefore,healthcare professionals should provide appropriate discharge planning for patients to manage any health issues that might prolong their length of stay and enhance caregivers’confidence to decrease the delay in hospital discharge of these patients.
Keywords: Delayed hospital discharge,Patients, Caregivers, Healthcare professionals

Article Details

How to Cite
1.
Sreeprasarn P, Sereewichayasawad N, Neelapaichit N. Factors Associated with Delayed Hospital Discharge among Patients being Transferred to Home Health Care Unit. Nurs Res Inno J [Internet]. 2021 Aug. 29 [cited 2024 Apr. 25];27(2):247-64. Available from: https://he02.tci-thaijo.org/index.php/RNJ/article/view/243015
Section
บทความวิจัย

References

Office of the National Economic and Social Development Council(NESDC) The proportion of health costs and the total household expenditure (GDP) year from 1993-2016.Available from website:http://social.nesdb.go.th/

SocialStat/StatReport_Final.aspx?reportid=1260&template=1R1C&yeartype=M&subcatid=18 (in Thai)

National Health Security Office(NHSO). National health administration guidebook: consolidated management of medical services.1st ed.Bangkok:Tanapress;2015.(inThai)

Majeed MU, Williams DT,Pollock R, AmirF, Liam M,Foong KS, et al. Delay in discharge and its impact on

unnecessary hospital bed occupancy. BMC Health ServRes.2012;12(1):410-6.doi:10.1186/1472-6963-12-410.

Challis D, Hughes J, Xie C, Jolley D. An examination of factors influencing delayed discharge of older people from hospital.Inter J Geriatr Psychiatry. 2013;29(1):106-14.

Zhao EJ, Yeluru A, Manjunath L, Zhong LR, Hsu HT,Lee CK, et al. A long wait:barriers to discharge for long

length of stay patients.PostgradMedJ. 2018;94(1116):546-50.doi: 10.1136/postgradmedj-2018-135815.

Lim SC, Doshi V, Castasus B, Lim JKH, Mamun K.Factors causing delay in discharge of elderly patients in an

acute care hospital. Annals Academy of Medicine. 2006;35(1):27-32.

Patel H, Yirdaw E, Yu A, Lisa Slater, Perica K, Pierce RG,etal.Improving Early Discharge Using a Team-Based

Structure for Discharge Multidisciplinary Rounds. Prof Case Manag. 2019;24(2):83-9. doi: 10.1097/

NCM.0000000000000318.

BarbaR,MarcoJ,CanoraJ,PlazaS,JuncosSN,HinojosaJ, et al. Prolonged length of stay in hospitalized internal

medicine patients. Eur J InternMed. 2015;26(10):772-5.doi: 10.1016/j.ejim.2015.10.011.

Lenzi J, Mongardi M, Rucci P, Ruscio ED, Vizioli M,Randazzo C, et al. Sociodemographic, clinical and

organisational factors associated with delayed hospital discharges:across-sectional study.BMC Health ServRes.

;14:128.doi: 10.1186/1472-6963-14-128.

Gehlbach BK, Salamanca VR, Levitt JE, Sachs GA,Sweeney MK,Pohlman AS, et al.Patient-related factors

associated with hospital discharge to a care facility after critical illness. Am J Crit Care. 2011;20(5), 378-86.

Sreeprasarn P, Neelapaichit N. Effect of Proactive Discharge Planning on Delayed Hospital Discharge in

Neurosurgical Patients. The Bangkok Medical Journal.2020;16(1):62-6. (in Thai)

Bai AD, Dai C, Srivastava S, Smith CA, Gill SS. Risk factors, costs and complications of delayed hospital

discharge from internal medicine wards at a Canadian Academic Medical Centre: retrospective cohort study.

BMC Health Serv Res. 2019; 19Z(35):1-9. doi.org/10.1186/s12913-019-4760-3.

Akkayagorn L, Chatrkaw P,SriratanabalP,Manasvanich B, Sa-nguansap T, Meethavorn N, et al. Definition and

influencing factors of difficulty hospital discharge using focus group. ChulaMedJ.2017;61(4):511–24.(inThai)

Tan WS, Chong WF, Chua KS, Heng BH, Chan KF.Factors Associated with Delayed Discharges after Inpatient

Stroke Rehabilitation in Singapore. Ann Acad Med Singapore. 2010;39(6):435-41.

MooreG,HartleyP,Romero-OrtunoR.Health and social factors associated with a delayed discharge amongst

inpatients in acute geriatric wards: A retrospective observational study. Geriatr Gerontol Int. 2018;18(4):

-7.doi: 10.1111/ggi.13212.

Rohatgi N, Kane M, Winget M, Haji-Sheikhi F, Ahuja N.Factors Associated With Delayed Discharge on General

Medicine Service at an Academic Medical Center. J Healthc Qual. 2018;40(6):329-35. doi:10.1097/

JHQ.0000000000000126.

Ou L, ChenJ,Young L,SantianoN, Baramy LS,Hillman K. Effective discharge planning - timely assignment of an

estimated date of discharge. Aust Health Rev.2011;35(3):357-63.doi: 10.1071/AH09843.

McKeehan KM. Continuing care: a multidisciplinary approach to discharge planning.St. Louis:Mosby, 1981.

Anderson MA, Helms L. An assessment of discharge planning models: communication in referrals for home

care. Orthop Nurs.1993;12(4):41-9. doi: 10.1097/00006416-199307000-00012

FaulF. G*Powerversion 3.1.9.2 [Internet]. 2014 [cited 2014 April 24]. Available from: https://www.poycho.

uni-duessldorf.de/abteilungen/aap/gpower3/

Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. New Jersey: Lawrence Erlbaum

Associates Publishers; 1988.

PanthongP,PhatisenaT. The Empowerment of Caregivers for Rehabilitation of Stroke Patients at Maharat Nakhon Ratchasima Hospital.DPC. 2018;24(2):57-66.(inThai)

Jitapunkul S, Kamolrattnankul P. Disability among the elderly living in Klong Toey Slum. J Med Assoc

Thai.1994;77:231-8. (in Thai)

JitapunkulS1, Khovidhunkit W. Urinary incontinence in Thai elderly living in Klong Toey slum.J Med Assoc Thai.1998;81(3):160-8. (in Thai)

Srijumnong N, Rawiworakul T, LagampanS, Malatham P.The effect of self-efficacy promotion program for family caregivers of person with stroke at home.Journal of Health and Nursing Research. 2010;26(1):28-40. (in Thai)

Kawiwitwichai J. Relationship between selected factors uncertain feelings about illness social support and

adaptation of breast cancer patients who received chemotherapy. Bangkok: Mahidol University; 1993.(in Thai)

Rojas-García A, TurnerS,Pizzo E, Hudson E, Thomas J, Raine R. Impact and experiences of delayed discharge:

A mixed-studies systematic review. Health Expect.2018;21(1):41-56.

Everall AC, GuilcherSJT, Cadel L, AsifM, LiJ, Kuluski K, et al. Patient and caregiver experience with delayed

discharge from a hospital setting:a scoping review.Health Expect. 2019;22(5):863-73.