Reasons for delayed discharge of trauma patients

Karen Brasel, Jason Rasmussen, Charline Cauley, John A. Weigelt

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Background. In the trauma population, increased length of stay is associated with age, comorbidities, and injury severity. We hypothesized that a significant contributor to a delay in length of stay was unrelated to these variables. Materials and methods. All trauma patients admitted for > 48 h with acute injury from 7/1/2000 to 9/30/2000 were evaluated daily for discharge readiness. Actual discharge time was recorded from the time discharge orders were written. A discharge-ready patient not discharged within 24 h was a Delay discharge. Discharge delay was categorized as availability of rehabilitation beds, family reasons, or system-related delay. Payer was classified as commercial, government, Medicare, or uninsured. Actual hospital costs were used. Results. One hundred twenty-eight patients were evaluated; 30 patients had a delay in discharge. The average delay was 2 days (range 1-15 days). Mean hospital stay for Delay patients was 13.4 days, and 8.1 days for Timely patients (P <0.05). Injury severity, age, and comorbidities were not different among groups. The main reason for delay was lack of a rehabilitation bed. Hospital costs were $39,013 per patient in the Delay group and $24,414 in the Timely group. Delay patients were more likely to be uninsured, have an orthopedic injury, and require ICU care. Conclusion. Discharge delays significantly lengthen hospital stay for nonmedical reasons in trauma patients. Improved efficiency in a trauma system will require changes from acute care to rehabilitation.

Original languageEnglish (US)
Pages (from-to)223-226
Number of pages4
JournalJournal of Surgical Research
Volume107
Issue number2
DOIs
StatePublished - 2002
Externally publishedYes

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Patient Discharge
Wounds and Injuries
Length of Stay
Rehabilitation
Hospital Costs
Comorbidity
Medicare
Orthopedics

Keywords

  • Discharge
  • Injury severity
  • Insurance
  • Length of stay
  • Outcomes
  • Trauma

ASJC Scopus subject areas

  • Surgery

Cite this

Reasons for delayed discharge of trauma patients. / Brasel, Karen; Rasmussen, Jason; Cauley, Charline; Weigelt, John A.

In: Journal of Surgical Research, Vol. 107, No. 2, 2002, p. 223-226.

Research output: Contribution to journalArticle

Brasel, K, Rasmussen, J, Cauley, C & Weigelt, JA 2002, 'Reasons for delayed discharge of trauma patients', Journal of Surgical Research, vol. 107, no. 2, pp. 223-226. https://doi.org/10.1006/jsre.2002.6512
Brasel, Karen ; Rasmussen, Jason ; Cauley, Charline ; Weigelt, John A. / Reasons for delayed discharge of trauma patients. In: Journal of Surgical Research. 2002 ; Vol. 107, No. 2. pp. 223-226.
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