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