Where to next? An exploration of patients with disability and complex needs who leave acute care hospitals via an interim discharge pathway
Michele M. Foster
A B * , Jessica Bowley A , Vivien Houston B and David N. Borg A
A Griffith University, Menzies Health Institute Queensland, The Hopkins Centre: Research for Rehabilitation and Resilience, 170 Kessels Road, Nathan, Qld 4111, Australia.
B Metro South Health Hospital and Health Service, Division of Rehabilitation, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Qld 4102, Australia.
Australian Health Review 46(3) 355-360 https://doi.org/10.1071/AH21398
Submitted: 22 December 2021 Accepted: 15 April 2022 Published: 17 May 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.
Abstract
Objective To examine the characteristics and circumstances of admitted patients with disability who require individualised supports to leave hospital and who experience interim discharge arrangements.
Methods The study used a retrospective exploratory design. Medical chart reviews of patients with disability who required funded support to leave hospital were conducted. The records of 224 patients admitted to one of three hospital facilities in South-East Queensland, Australia, between May 2017 and January 2020 were reviewed. Information about hospital facility, demographic characteristics, disability type, support needs, discharge destination, and reasons for interim discharges were extracted for analysis.
Results Forty of 224 patients were discharged to an interim destination. Inter-hospital transfers were the most common interim discharge arrangement. Being divorced or separated was the only demographic variable associated with having an interim discharge arrangement for admitted patients with disability. More patients with disability who experienced an interim discharge required accommodation supports and behavioural supports compared to patients who were not involved in interim discharges.
Conclusions Patients with disability with minimal informal support and who rely on a sophisticated mix of individualised supports to leave hospital may be more susceptible to interim discharge arrangements. Early identification of these patients and formal mechanisms for ensuring continuous coordination of ongoing transitions and supports is critical to avoid sub-optimal outcomes. Future research is needed to capture a complete picture of the series of transitions of interim discharged patients with disability leaving acute care facilities and the quality of their supports and outcomes.
Keywords: accomodation, care complexity, discharge delay, hospital discharge, individualised funded supports, interim hospital transfer, National Disability Insurance Scheme, temporary.
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