Cases of bed blockage in Northern Spain during 2010–2014: Delayed discharge from acute hospitalization to long-term care

Background The term ‘bed blocking’ is used in a situation where “patients who no longer require acute care are occupying acute care beds while awaiting lower-level placement”. This term is related with delayed discharge and represent an inefficient use of acute hospital beds. Evidence about this topic describes characteristics associated with a higher likelihood of became a bed-blocking: older age, lack of functional ability, emergency case and hospital's weighting. Our aim is to determinate in our region, which characteristics may influence the problem and to quantify inadequate hospitalization's days. Methods A descriptive retrospective study of patients with delayed discharge from acute hospitalization to long-term care was conducted. This study involved three public hospitals from the region of northern of Spain (Cantabria), during 2010–2014. The variables collected includes: age, gender, planned or emergency admission, level of hospital, diagnosis-related group (DRG) and inadequate hospitalization's days. Mean and standard deviation were estimated to continuous variables. Proportions were estimated with confidence intervals at 95% (95% CI) to discrete variables. Means were compared with t de Student and Anova. Results In the period between 2010 to 2014, it is found 1415 bed-blocking's cases in hospitals from Cantabria, waiting to be admitted in a to long-term care. Spent a total of 19,183 inadequate hospitalization's days. Mean of delayed discharge: 13.56 days [SD 14.34], range 1 to 131; 66.7% are delayed less than two weeks; 53.1% male and 46.9% female. Gender were not found to be significantly associated with delayed discharges but women [mean age 80.70] are significantly older than men [mean age 75.99]. The mean age of our population was 78.49 years [SD 10.48], range 27 of 102; 74.6% are older than 75 years but younger inpatients had delayed significantly longer; 94.1% of cases were emergency patients. Diagnosis-related group (DRG) more frequents were hip fracture (8.0%), stroke (7.5%), other central nervous system's disorder (5.6%) and simple pneumonia (4.0%). Compared with local hospital, the university hospital had delayed significantly longer. Conclusion Inpatient's characteristics related with bed blocking risk: older than 75, emergency admission in a university hospital and diagnosis that suppose unexpected lack of functional ability. Relation between gender and age could be related with gender role of caregiver. These results may reflect that university hospitals treat the more complex patients. Known the inpatient's characteristics, an early detection since the emergency admission could solve the delayed and prevent this inefficient use of acute hospital beds.