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Abstract
Background
Community-acquired pneumonia is one of the most common diseases in elderly persons and usually results in a prolonged hospital stay. Discharge planning plays an important role in reducing the length of hospitalization. This study was designed to determine whether early screening for risk factors for delayed discharge could improve the quality of discharge planning.
Methods
This retrospective, observational study was conducted in two medical facilities from January 2016 to December 2018. Hospital A used a screening tool on admission (screening group): screening for risk factors for delayed discharge and initiating discharge planning immediately for those for whom it was applicable, and discharge planning in the stable phase for those for whom it was not applicable; and Hospital B initiated discharge planning without screening (usual group). Propensity score-matched pneumonia patients in the two groups were then compared. The primary outcome was length of hospital stay.
Results
A total of 648 patients were enrolled in this study. After adjusting for age, sex, aspiration, comorbidity, pneumonia severity index, and key person, 118 pairs underwent analysis. Length of stay was significantly different (20 days vs 13 days, p<0.001) between the groups. There were no differences in duration of antibiotic treatment, in-hospital mortality, and 30-day readmission (9 days vs 9 days, p=0.744; 10 (8.5%) vs 10 (8.5%), p=1.000; 10 (8.5%) vs 9 (7.6%), p=0.811, respectively).
Conclusion
Early screening for delayed discharge improved the quality of discharge planning by reducing the length of stay in pneumonia patients.
Acknowledgments
The authors would like to thank and acknowledge the cooperation of all of the participants in the study who volunteered their time and gave accounts of experiences without which none of the work would have been possible.
Abbreviations
CAP, community-acquired pneumonia; DP, Discharge planning; RN, registered nurse; ICD-10, International Classification of Diseases, 10th revision; HCAP, healthcare-associated pneumonia; HAP, hospital-acquired pneumonia; CCI, Charlson Comorbidity Index; PSI, Pneumonia Severity index; DOC, disorder of consciousness; BMI, body mass index; CI, confidence interval.
Data Sharing Statement
The raw data are available by email on reasonable request to the corresponding author.
Ethics Approval and Consent to Participate
Ethical approval for the study was obtained from the institutional review boards of Yokohama City University and Kanto Rosai Hospital (reference numbers B190600008 and K2018002, respectively).
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The authors declare that they have no competing interests.