eprintid: 1575492 rev_number: 36 eprint_status: archive userid: 608 dir: disk0/01/57/54/92 datestamp: 2017-09-27 10:18:21 lastmod: 2022-01-25 23:46:53 status_changed: 2017-09-27 10:18:21 type: article metadata_visibility: show creators_name: Rojas-García, A creators_name: Turner, S creators_name: Pizzo, E creators_name: Hudson, E creators_name: Thomas, J creators_name: Raine, R title: Impact and experiences of delayed discharge: A mixed-studies systematic review ispublished: inpress divisions: UCL divisions: B16 divisions: B14 divisions: J81 divisions: B02 divisions: C07 divisions: D79 divisions: D12 divisions: G21 keywords: OECD, cost, delayed discharge, impact, outcome, qualitative, systematic review, timely discharge note: Copyright © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. abstract: BACKGROUND: The impact of delayed discharge on patients, health-care staff and hospital costs has been incompletely characterized. AIM: To systematically review experiences of delay from the perspectives of patients, health professionals and hospitals, and its impact on patients' outcomes and costs. METHODS: Four of the main biomedical databases were searched for the period 2000-2016 (February). Quantitative, qualitative and health economic studies conducted in OECD countries were included. RESULTS: Thirty-seven papers reporting data on 35 studies were identified: 10 quantitative, 8 qualitative and 19 exploring costs. Seven of ten quantitative studies were at moderate/low methodological quality; 6 qualitative studies were deemed reliable; and the 19 studies on costs were of moderate quality. Delayed discharge was associated with mortality, infections, depression, reductions in patients' mobility and their daily activities. The qualitative studies highlighted the pressure to reduce discharge delays on staff stress and interprofessional relationships, with implications for patient care and well-being. Extra bed-days could account for up to 30.7% of total costs and cause cancellations of elective operations, treatment delay and repercussions for subsequent services, especially for elderly patients. CONCLUSIONS: The poor quality of the majority of the research means that implications for practice should be cautiously made. However, the results suggest that the adverse effects of delayed discharge are both direct (through increased opportunities for patients to acquire avoidable ill health) and indirect, secondary to the pressures placed on staff. These findings provide impetus to take a more holistic perspective to addressing delayed discharge. date: 2017-09-12 date_type: published official_url: http://doi.org/10.1111/hex.12619 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1423759 doi: 10.1111/hex.12619 lyricists_name: Hudson, Emma lyricists_name: Pizzo, Elena lyricists_name: Raine, Rosalind lyricists_name: Rojas-Garcia, Antonio lyricists_name: Thomas, James lyricists_id: EHUDS22 lyricists_id: EPIZZ45 lyricists_id: RABEN42 lyricists_id: AROJA64 lyricists_id: JTHOA32 actors_name: Rojas-Garcia, Antonio actors_id: AROJA64 actors_role: owner full_text_status: public publication: Health Expectations event_location: England issn: 1369-7625 citation: Rojas-García, A; Turner, S; Pizzo, E; Hudson, E; Thomas, J; Raine, R; (2017) Impact and experiences of delayed discharge: A mixed-studies systematic review. Health Expectations 10.1111/hex.12619 <https://doi.org/10.1111/hex.12619>. (In press). Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/1575492/1/Rojas-Garc-a_et_al-2017-Health_Expectations.pdf