Length of Hospital Stay and Discharge Delays in Stroke Patients

Author:

van Straten A.1,van der Meulen J.H.P.1,van den Bos G.A.M.1,Limburg M.1

Affiliation:

1. the Institute of Social Medicine (A. van S., G.A.M. van den B.), the Department of Neurology (A. van S., M.L.), and the Department of Clinical Epidemiology and Biostatistics (J. van der M.), Academic Medical Center, University of Amsterdam (Netherlands).

Abstract

Background and Purpose 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 rea son 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.”

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

Reference30 articles.

1. Schuling J. Stroke Patients in General Practice . Groningen Netherlands: University of Groningen; 1993. Dissertation.

2. Limburg M. Stroke: Aspects of Diagnosis and Management . Amsterdam Netherlands: University of Amsterdam; 1992. Dissertation.

3. Information Centre for Health Care (SIG). Jaarboek voor de Ziekenhuizen . Culemborg Netherlands: Technipress; 1994.

4. Do stroke units save lives?

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