Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen · 2026
[Delays on the day of hospital discharge: An exploratory analysis of retrospective and prospective data on patient-related and process-related factors].
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Rieder Simon, Serk Johannes, Rosendahl Jonas, Klose Johannes, Ronellenfitsch Ulrich, Döbereiner Jessica, Sekulla Carsten, Kleeff Jörg, Rebelo Artur
Аннотация
BACKGROUND: Delays on the day of hospital discharge place a significant burden on hospital resources, disrupt patient flow, and delay the release of bed capacity. The aim of this study was to identify the main causes and risk factors for delayed discharges, considering patient characteristics and discharge processes.
METHODS: The exploratory study is based on a retrospective and prospective survey conducted on a surgical and an internal medicine ward of a university hospital. In the retrospective survey, discharge dates, demographic and clinical data, discharge type, comorbidities, and discharge destination were recorded. The prospective survey was conducted over four weeks. All patients undergoing full inpatient treatment were analyzed consecutively, and a questionnaire was used as a tool.
RESULTS: A total of 12,634 patients were regularly discharged from both wards between 2019 and 2021. Of these, 946 patients (7.5%) were discharged on time (before 10:00 a.m.), 5,003 patients (39.6%) were discharged slightly delayed, and 6,685 patients (52.9%) were discharged very late (after 12:00 p.m.). The identified risk factors for delayed discharge included short-notice discharge decisions, advanced age, multimorbidity, prolonged hospital stays, and time-consuming diagnostic procedures on the day of discharge. In the prospective part of the study (n = 264), discharge was on time in 5.3% of patients, slightly delayed in 49.2%, and very late in 45.4% of patients. The main factors contributing to delayed discharges were delayed preparation of medical documentation, patients not being ready to leave, late scheduling of transportation, and discharge to home.
CONCLUSION: These results emphasize the need for structured discharge planning and individual, risk-based assessment of each patient's readiness for discharge (e.g., based on age, multimorbidity, PCCL, and level of care) to minimize delays in the discharge process.
METHODS: The exploratory study is based on a retrospective and prospective survey conducted on a surgical and an internal medicine ward of a university hospital. In the retrospective survey, discharge dates, demographic and clinical data, discharge type, comorbidities, and discharge destination were recorded. The prospective survey was conducted over four weeks. All patients undergoing full inpatient treatment were analyzed consecutively, and a questionnaire was used as a tool.
RESULTS: A total of 12,634 patients were regularly discharged from both wards between 2019 and 2021. Of these, 946 patients (7.5%) were discharged on time (before 10:00 a.m.), 5,003 patients (39.6%) were discharged slightly delayed, and 6,685 patients (52.9%) were discharged very late (after 12:00 p.m.). The identified risk factors for delayed discharge included short-notice discharge decisions, advanced age, multimorbidity, prolonged hospital stays, and time-consuming diagnostic procedures on the day of discharge. In the prospective part of the study (n = 264), discharge was on time in 5.3% of patients, slightly delayed in 49.2%, and very late in 45.4% of patients. The main factors contributing to delayed discharges were delayed preparation of medical documentation, patients not being ready to leave, late scheduling of transportation, and discharge to home.
CONCLUSION: These results emphasize the need for structured discharge planning and individual, risk-based assessment of each patient's readiness for discharge (e.g., based on age, multimorbidity, PCCL, and level of care) to minimize delays in the discharge process.