P W New1. 1. 1] Spinal Rehabilitation Service, Caulfield Hospital, Alfred Health, Melbourne, Victoria, Australia [2] Epworth-Monash Rehabilitation Medicine Unit, Monash University, Melbourne, Victoria, Australia.
Abstract
STUDY DESIGN: Prospective open cohort case series of consecutive patients admitted with spinal cord damage to a spinal rehabilitation unit (SRU) between 1 January 2008 and 31 July 2013. OBJECTIVES: Measure the prevalence of barriers to discharge, their reasons and resulting additional unnecessary days in hospital. SETTING: SRU, Victoria, Australia. METHODS: Consecutive SRU admissions had prospective documentation of key clinical and demographic characteristics, the occurrence of any discharge barrier, the cause(s) and duration of unnecessary hospitalisation. RESULTS: There were 235 patients in the study; 138 (58.7%) were male and the median age was 63 years. Eighty-six (36.6%) patients had a discharge barrier. The most common reasons for a discharge barrier were: waiting for approval for long-term and supported care or services, residential care, home modifications, family deliberations regarding discharge planning and the provision of equipment necessary for discharge. The reasons accounting for the greatest number of additional hospital days were: home modifications, residential care, equipment necessary for discharge, waiting for approval for long-term and supported care or services and accommodation for people unable to return to their previous residence without readily available alternatives. Over the study period 17.5% (3176/18,184) of all bed-days were occupied by patients deemed to be clinically ready for discharge from the SRU but who had a discharge barrier. CONCLUSIONS: Barriers to discharge from rehabilitation for patients with spinal cord damage are common, substantial, and represent an important opportunity for health systems improvement.
STUDY DESIGN: Prospective open cohort case series of consecutive patients admitted with spinal cord damage to a spinal rehabilitation unit (SRU) between 1 January 2008 and 31 July 2013. OBJECTIVES: Measure the prevalence of barriers to discharge, their reasons and resulting additional unnecessary days in hospital. SETTING: SRU, Victoria, Australia. METHODS: Consecutive SRU admissions had prospective documentation of key clinical and demographic characteristics, the occurrence of any discharge barrier, the cause(s) and duration of unnecessary hospitalisation. RESULTS: There were 235 patients in the study; 138 (58.7%) were male and the median age was 63 years. Eighty-six (36.6%) patients had a discharge barrier. The most common reasons for a discharge barrier were: waiting for approval for long-term and supported care or services, residential care, home modifications, family deliberations regarding discharge planning and the provision of equipment necessary for discharge. The reasons accounting for the greatest number of additional hospital days were: home modifications, residential care, equipment necessary for discharge, waiting for approval for long-term and supported care or services and accommodation for people unable to return to their previous residence without readily available alternatives. Over the study period 17.5% (3176/18,184) of all bed-days were occupied by patients deemed to be clinically ready for discharge from the SRU but who had a discharge barrier. CONCLUSIONS: Barriers to discharge from rehabilitation for patients with spinal cord damage are common, substantial, and represent an important opportunity for health systems improvement.
Authors: P W New; A Townson; G Scivoletto; M W M Post; I Eriks-Hoogland; A Gupta; E Smith; R K Reeves; Z A Gill Journal: Spinal Cord Date: 2012-07-17 Impact factor: 2.772
Authors: M C Pagliacci; M G Celani; L Spizzichino; M Zampolini; S Aito; A Citterio; G Finali; D Loria; S Ricci; M Taricco; M Franceschini Journal: Spinal Cord Date: 2003-11 Impact factor: 2.772
Authors: P W New; G Scivoletto; É Smith; A Townson; A Gupta; R K Reeves; M W M Post; I Eriks-Hoogland; Z A Gill; M Belci Journal: Spinal Cord Date: 2013-07-30 Impact factor: 2.772
Authors: Steven L Bernstein; Dominik Aronsky; Reena Duseja; Stephen Epstein; Dan Handel; Ula Hwang; Melissa McCarthy; K John McConnell; Jesse M Pines; Niels Rathlev; Robert Schafermeyer; Frank Zwemer; Michael Schull; Brent R Asplin Journal: Acad Emerg Med Date: 2008-11-08 Impact factor: 3.451
Authors: Anthony S Burns; Argelio Santos; Christiana L Cheng; Elaine Chan; Nader Fallah; Derek Atkins; Marcel F Dvorak; Chester Ho; Henry Ahn; Jerome Paquet; Brian K Kwon; Vanessa K Noonan Journal: J Neurotrauma Date: 2017-03-29 Impact factor: 5.269