title: Delay in discharge and its impact on unnecessary hospital bed occupancy.
abstract: BACKGROUND
  Elderly patients are potentially more vulnerable to prolonged hospital stay as they frequently require additional resources to facilitate their discharge. In an acute hospital setting, we aimed to quantify and compare length of stay (LOS) for all patients over and under the age of 65, and identify the number and cause of days lost under the care of a single surgical unit.
  
  
  METHODS
  Over a 4 month period from January to April 2010, data on the management and source of potential delay was collected daily on consecutive patients admitted and discharged under the care of one consultant surgeon at a district general hospital. Statistical analysis was then performed with particular focus on actual delays affecting elderly patients.
  
  
  RESULTS
  A total of 99 complete inpatients episodes were recorded. There were 30 elective and 69 acute admissions. 10 (33%) elective vs. 42 (61%) acute patients encountered delays, losing 39 and 232 days respectively (χ2 [1, N = 99] = 6.36, p = .012). 23 of a total 39 elderly patients admitted acutely required specialist care of the elderly opinion and placement in community hospitals resulting in delays of 188 days. vs. 36 days for the 16 discharged home and 8 days for 30 patients under 65 (χ2 (2, N = 69) = 26.54, p = <.001).
  
  
  CONCLUSIONS
  Elderly patients experiencing acute surgical admission and discharge to community hospitals had prolonged LOS due to significant delays associated with care of the elderly provision. The financial considerations behind bed capacity in primary and secondary care and the provision of care of elderly services need to be balanced against unnecessary occupancy of acute hospital beds with its associated health and economic implications.
authors.affiliation: Department of Vascular Surgery, Ysbyty Gwynedd Hospital, Bangor, LL57 2PW, UK. umairmajeed188@gmail.com
authors.forename: Muhammad Umair
authors.initials: MU
authors.lastname: Majeed
authors.forename: Dean Thomas
authors.initials: DT
authors.lastname: Williams
authors.forename: Rachel
authors.initials: R
authors.lastname: Pollock
authors.forename: Farhat
authors.initials: F
authors.lastname: Amir
authors.forename: Martin
authors.initials: M
authors.lastname: Liam
authors.forename: Keen S
authors.initials: KS
authors.lastname: Foong
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Whitaker
mesh_terms: D000367:Age Factors; D000368:Aged; D001509:Bed Occupancy / Q000706:statistics & numerical data*; D005260:Female; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006767:Hospitals, District / Q000706:statistics & numerical data; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data*