Characteristics of patients in a ward of Academic Internal Medicine. Implications for medical care, training programs and research

Objective: To describe the characteristics of \u201cdelayed discharge patients\u201d and the factors associated with \u201cdelayed discharges\u201d. Material and methods: We performed a 12-month observational study on patients classified as \u201cdelayed discharge patients\u201d admitted to an Academic Internal Medicine ward. We assessed the demographic variables, the number and severity of diseases using the Geriatric Index of Comorbidity (GIC), the cognitive, affective and functional status using respectively the Mini Mental Stare Examination (MMSE), the Geriatric Depression Scale (GDS) and the Barthel Index. We assessed the total length of stay (T-LHS), the total inappropriate length of stay (T-ILHS), the median length of stays (M-LHS), the median inappropriate length of stay (M-ILHS) and evaluated the factors associated with delayed discharge. Results: \u201cdelayed discharge patients\u201d were 11.9% of all patients. The mean age was 81.9 years, 74.0% were in the IV class of GIC and 33.5% were at the some time totally dependent and affected by severe or not assessable cognitive impairments. The patients had 2584 T-LHS, of which 1058 (40.9%) were T-ILHS. Their M-LHS was 15 days, and the M-ILHS was 5 days. In general the more is the LHS, the more are the ILHS (Spearman\u2019s rho + 0.68, p