Role of discharge planning and other determinants in total discharge time at a large tertiary care hospital

• Main Authors: Shweta Mehta, Jayesh Nair, Sunil Rao, Kasturi Shukla
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2015-01-01
• Series: CHRISMED Journal of Health and Research
• Subjects: Clearance; department; determinants; discharge time; hospital
• Online Access: http://www.cjhr.org/article.asp?issn=2348-3334;year=2015;volume=2;issue=1;spage=46;epage=50;aulast=Mehta
• ISSN: 2348-3334; 2348-506X

Introduction: Discharge time, a crucial quality indicator, is dependent on several other factors like clearance time and patient-related issues. The present study analyzes these determinants and presents measures to control the discharge time. Materials and Methods: This cross-sectional study was conducted during May-June 2013 at a large multispecialty hospital. During initial 15 days, that is, the pilot study, data was collected across various steps where time was consumed during discharge process and initiatives were taken to increase the number of planned discharges. For the main study, discharges were classified as planned/unplanned and patients as insured and uninsured. Results of pilot study and main study were compared. We computed one-sample t-test on overall discharge time, clearance time, and independent sample t-test on discharge time consumed for types of discharges. All results with P < 0.05 were considered statistically significant. Results: Out of 105 discharges, 75 were included wherein mean discharge time of 177.6 (± 613) min was significantly lower than the mean time of 285.42 (±105.46) min taken for 35 discharges during pilot study (P < 0.01). Mean discharge time of 572 (±1378.4) min for the 14 insured patients was significantly higher (P < 0.0001) than the 61 uninsured patients where discharge time was 88 (±84.7) min. Mean discharge time for planned discharges (n = 18) was 85 (±87.9) min that was significantly lower than unplanned discharges (n = 57) with a mean of 524 (±1446.6) min (P < 0.01). ther patient-related factors like, delay in bill payment, request for discounts further increased the discharge time. Conclusion: Planning the discharges reduced the total time of discharge process substantially. Discharge time was substantially high for insured patients that need to be controlled. Departmental clearance and patient-related factors also impact the discharge time.