51. Influencing factors for delayed discharge following day surgery: A retrospective case–control study.
- Author
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Zhu, Wei, Huang, Mingjun, Dai, Yan, and Li, Jiping
- Subjects
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HYPERTENSION , *ACADEMIC medical centers , *ACQUISITION of data methodology , *GENERAL anesthesia , *FEVER , *CONFIDENCE intervals , *TIME , *MULTIPLE regression analysis , *DIZZINESS , *SURGICAL clinics , *RETROSPECTIVE studies , *CASE-control method , *SURGERY , *PATIENTS , *SURGICAL complications , *POPULATION geography , *FISHER exact test , *MANN Whitney U Test , *RISK assessment , *METABOLIC disorders , *MEDICAL records , *EMPLOYMENT , *HEALTH insurance , *DESCRIPTIVE statistics , *CHI-squared test , *AMBULATORY surgery , *STATISTICAL sampling , *METROPOLITAN areas , *DATA analysis software , *HYPOTENSION , *DISCHARGE planning , *COMORBIDITY , *POSTOPERATIVE pain , *HEMORRHAGE - Abstract
Aim: We aimed to identify the risk factors for delayed discharge in a day surgery centre in west China. Background: Delayed discharge affected by various factors is a key indicator for healthcare quality of day surgery. However, few studies have focused on this issue in developing countries where the day surgery started much later. Design A retrospective case–control design. Method: A random sample of 169 delayed discharge cases and 514 normal discharge cases was randomly selected from 38,021 day surgery cases from May 2011 to May 2019 in a tertiary teaching hospital in west China. Socio‐demographic and clinical characteristics of patients were collected through the hospital electronic database and a chart review. A multivariate logistic regression was conducted to identify the risk factors for delayed discharge. Results: The urban employee basic medical insurance, comorbidity, general anaesthesia, pain, fever, bleeding and metabolic disorder were identified as the risk factors for delayed discharge. Living in the city where the hospital located was a protective factor for delayed discharge. Conclusion: Post‐operative complications including fever, pain, bleeding and metabolic disorder were the most important risk factors for delayed discharge. The pre‐operative prevention, careful monitoring and rapid reactions to post‐operative complications may reduce delayed discharge. Summary statement: What is already known about this topic? Day surgery is conducted worldwide due to its time‐saving, cost‐effectiveness and low risk for post‐operative infection.Delayed discharge is considered as one of the most important indicators for healthcare quality of a day surgery centre.Most of the identified risk factors for delayed discharge are from the developed countries' experience of day surgery and remain controversial. What this paper adds? The insurance reimbursement rate influenced patients' willingness for discharge.Living in the same city where the hospital is located was a protective factor for delayed discharge.Post‐operative metabolic disorder was a risk factor for delayed discharge. The implications of this paper: Reducing the insurance reimbursement rate of patients who meet discharge criteria but ask for longer hospital stays may be helpful to reduce delayed discharge.Careful monitoring and rapid response to post‐operative complications may be simple but useful measures to reduce the risk of delayed discharge. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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