Università degli Studi di Modena e Reggio Emilia
Corso di laurea in infermieristica - Sede di Modena
| Thesis Title | Clinical, social and helpful variables related to delayed discharges in an acute psychiatric ward: a 6 years retrospective analysis |
|---|---|
| Name | Panza Leda |
| Supervisor(s) | Ferri Paola |
| Academic Year | 2015/16 |
| Thesis type | Non research thesis |
Abstract
Background. The term “bed blocker” indicates inpatients who, after completing the diagnostic and therapeutic process, achieve good clinical compensation, but cannot be discharged due to issues not directly related to clinical diseases. Literature reports a growing interest in patients affected by severe psychiatric illness who use services dedicated to the management of acute diseases for prolonged periods.
Materials and methods. The survey was conducted in the Psychiatric Diagnosis and Treatment Service of Az-USL in Modena, located within the General Hospital (NOCSAE) of Baggiovara. From 1-1-2010 to 31-12 2015 we collected 158 delayed discharges, according to the literature, (>29 day hospitalizations, 95th percentile of median). We evaluated the median duration of these hospitalizations (38 days), according to which we divided all the admissions during the study period into two groups: hospitalizations ≤38 days (n = 3261) and hospitalizations ≥39 days (n = 74). Some demographic and clinical variables, retrospectively selected from medical records, were compared between the two groups (chi2 test, t-test, multivariate logistic regression). The duration of hospitalizations was correlated with the selected variables (single and multivariate linear regression).
Results. Our analysis found that the length of hospitalizations is significantly related to a social variable, being homeless and/or have a foreign residency, and many clinical variables: the severity of diseases, most often schizophrenic psychosis, aggressive behaviour, especially severe type, poor therapeutic compliance in compulsory treatment and the need for complex therapeutic and rehabilitation programs.
Conclusions. The analysis of delayed discharges can deepen not only many important economic and organizational aspects but also clinical, ethical and social issues of care, since long stay hospitalizations may induce institutional dependency, inducing chronic course of patients’ illnesses.