Hospital bed shortages that result in early discharge to make room for other patients may increase the risk of death following hip surgery, according to the findings of new research.
In a study published in the medical journal Clinical Epidemiology, Norwegian researchers reviewed data for patients who underwent surgery following a hip fracture, to examine the effects of early hospital discharge.
Discharge tendency was defined as the proportion of patients with other acute conditions who were discharged on a given day. Researchers used data from nearly 5 million hospitalizations to determine the discharge tendency for any given day, including nearly 60,000 Norwegian patients with hip fractures who were hospitalized between 2008 and 2016. They had an average age of 70 years and older.
The probability of discharge among hip fracture patients increased by 5.5% per 10% increase in hospital discharges among patients with other acute conditions.
When beds were scarce in hospitals, patients who suffered hip fractures were more likely to be discharged early. The most likely times for early discharges were Fridays, the day before holidays, and times when hospitals were overbooked.
According to the data, the increased risk of death that could be attributed to a discharge from organizational causes was estimated at 3.7% points.
Many patients who undergo hip fractures are older than 80 and suffer from chronic illnesses, making them a more vulnerable group.
When those early discharges stem from lack of bed space in a hospital, those patients face an increased risk of death, according to the researchers.
In Norway, half of patients had bed rest for five days or less in 2016. Comparatively 25% of patients in 2010 had bed rest for five days. If discharge time decreases due to better treatment, that indicates an improvement in care. But if discharge times decrease due to lack of bed space, this can worsen patient outcomes.