Delayed discharge from rehabilitation after brain injury.
OBJECTIVE
To investigate the extent of, and factors contributing to, delayed discharges for younger adults in rehabilitation.


METHODS
Survey of patients discharged and awaiting discharge in a six-month period in five centres across England operated by a leading independent sector provider. Discharge was classified as delayed if a person had been waiting more than 30 days for transfer.


RESULTS
One in three beds was occupied by a delayed discharge (median delay > seven months). Common reasons were absence of a suitable placement (41%) and failure to obtain funding for postdischarge support (31%). Delays were also associated with poor indoor mobility and additional physical/mental health problems. We estimated earlier discharge would have resulted in overall cost savings of almost ł490 000.


CONCLUSIONS
Delayed discharge remains a significant obstacle to the development of cost-effective care pathways for younger adults. Our study suggests that health and social services are not exploiting the UK government's legislation for flexible partnership working in this area.
Worthington
Andrew D
AD
Brain Injury Rehabilitation Trust, West Heath House, Birmingham, UK. aworthington@birt.co.uk
Oldham
J Barrie
JB
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000534:rehabilitation*; D017598:Efficiency, Organizational; D004739:England; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012046:Rehabilitation / Q000458:organization & administration; D014600:Utilization Review; D014852:Wales