title: Discharge Delays for Patients Requiring In-Hospital Guardianship: A Cohort Analysis.
abstract: To assess nonclinical factors delaying hospital discharge of guardianship patients.
  
  
  
  Utilization review data over 3 years.
  
  
  
  Retrospective cohort study.
  
  
  
  Mann-Whitney test was used to compare patients' medically unnecessary days (MUD) of hospitalization with additional subcategories of delays-defined as beyond clinicians' control.
  
  
  
  Overall median number of MUD was 19.5; 14 of 48 patients were additionally delayed while awaiting long-term care Medicaid approval (N = 7, 50%), pending insurance (N = 3, 21%), social or transportation difficulties (N = 3, 21%), or preadmission review (N = 1, 7%). The median number of MUD for the 14 delayed patients was 63, a difference of 53 days compared with the routine guardianship cohort (P < .0001) and $5.5M in net revenue opportunity.
  
  
  
  Nonclinical discharge delays for guardianship patients are costly and potentially unavoidable. Further exploration into policy change is therefore recommended.
authors.forename: Jasper J
authors.initials: JJ
authors.lastname: Chen
authors.forename: Christine T
authors.initials: CT
authors.lastname: Finn
authors.forename: Karen
authors.initials: K
authors.lastname: Homa
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: St Onge
authors.forename: Tracie A
authors.initials: TA
authors.lastname: Caller
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D005260:Female; D006760:Hospitalization; D006801:Humans; D007872:Legal Guardians; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors; D014481:United States