[Impact of delayed discharge for nonmedical reasons in a tertiary hospital internal medicine department]

Background: Delayed discharge occurs from a clinical point of view when a patient is considered medically fit for discharge but continues occupying a bed due to a nonmedical problem. This circumstance overloads the care system, however, its real frequency and loss of useful days of hospitalization have not being evaluated in Spain up to date.

Objective: To analyze the frequency of hospital delayed discharges due to non-medical reasons in a tertiary hospital Internal Medicine Department and to determine the clinical and socio-familial factors related to this situation.

Patients and methods: An observational and prospective study was performed to analyze the characteristics of the patients whose discharge was delayed for nonmedical reason over a 12-month period.

Results: There were 4850 discharges in the Internal Medicine Department, 170 (3.5%) of which were delayed because of nonmedical problems. This accounted for a loss of 1603 useful days of hospitalization for other patients within one year. The median delay was 5 days (range: 3-12). Patients with delayed discharges were elder and had a higher prevalence of acute cerebrovascular disease as well as alcohol or benzodiazepines use related problems. The main causes were the overload or inability of the family to care for the patient and the impossibility to combine patient care with the family's working life (51.8%), and lack of family or social support network (21.8%).

Conclusions: Delayed discharges for nonmedical reasons are frequent and mainly motivated by social-familiar problem to take charge of the patients after their hospitalization. This accounts for a significant overload for the hospitals.