“Associations between patient characteristics and unplanned or delayed discharges from geriatric rehabilitation: A retrospective chart review”

Abstract

Returning home is considered an indicator of successful rehabilitation for community-dwelling older adults. However, the factors associated with unplanned discharge remain uncertain. This retrospective chart review included patients aged 65 years and older admitted to a geriatric rehabilitation unit from medical and surgical wards in an academic hospital. Patient characteristics and outcomes were abstracted from the electronic medical record. The primary outcome was unplanned discharge destination defined as anything other than return to patients’ pre-existing residence. The associations between patient variables and unplanned discharge destination were analyzed using Pearson chi-squared and univariate logistic regression. Of the 251 charts screened, 25 patients (10.0%) had an unplanned discharge destination, and 74 of the remaining 226 (32.7%) experienced a delayed discharge (beyond 20 days). Requiring assistance for activities of daily living (OR 2.80 [95% CI 1.17–7.47]), a diagnosis of chronic obstructive pulmonary disease (OR 4.04 [95% CI 1.63–9.71]), and lower serum albumin level (OR 1.67 [95% CI 1.06–2.72]) were associated with unplanned discharge. Variables commonly associated with worse outcomes such as age, cognitive scores, delirium, and number of comorbidities were not barriers to returning home and should therefore not be used on their own to limit access to geriatric rehabilitation.