Length of hospital stay and discharge delays in stroke patients.
OBJECTIVE
In The Netherlands, many stroke patients stay in the hospital for some time merely waiting for discharge placement. This indicates an inefficient use of hospital resources, as well as a possible deficiency in the quality of care, because hospitals are not adequately equipped to care for these patients. In this study, we tried to quantify this "waiting problem."


METHODS
Six hospitals and 29 neurologists participated in this prospective study. The neurologists were asked during weekly interviews to specify for 154 patients the reason for retention in the hospital on a day-to-day basis. The reasons were noted on a list specified by the authors in advance.


RESULTS
The mean length of hospital stay was 28 days. On average, there were "hard" medical reasons for 15 days (54%) and "soft" medical reasons for 3 days (10%), whereas the remaining 10 days (36%) were explained by nonmedical reasons (most frequently, waiting for placement in a nursing home).


CONCLUSIONS
The length of hospital stay for stroke patients in The Netherlands can be reduced considerably without compromising the quality of care. This might be realized by increasing the capacity of long-term care facilities, improving the efficiency of the discharge procedures, or creating "stroke services."
van Straten
A
A
Institute of Social Medicine, Academic Medical Center, University of Amsterdam, Netherlands. a.vanstraten@amc.uva.nl
van der Meulen
J H
JH
van den Bos
G A
GA
Limburg
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders; D005260:Female; D006742:Hospital Bed Capacity; D006764:Hospitals, Community; D006785:Hospitals, University; D006801:Humans; D007407:Interviews as Topic; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009462:Neurology; D010351:Patient Discharge; D011446:Prospective Studies