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Most Weekday Discharge Times at Acute Care Hospitals in the State of Florida Occurred After 3 PM in 2022, Unchanged from Before the COVID-19 Pandemic.

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Title: Most Weekday Discharge Times at Acute Care Hospitals in the State of Florida Occurred After 3 PM in 2022, Unchanged from Before the COVID-19 Pandemic.
Authors: Epstein, Richard H.1 repstein@med.miami.edu, Dexter, Franklin2 Franklin-Dexter@UIowa.edu, Fahy, Brenda G.3 bfahy@anest.ufl.edu
Source: Journal of Medical Systems. 2/25/2025, Vol. 49 Issue 1, p1-6. 6p.
Subjects: Research funding, Data analysis, Discharge planning, Descriptive statistics, Statistics, Confidence intervals, Length of stay in hospitals, Time, COVID-19 pandemic, Health care rationing
Geographic Terms: Florida
Abstract: When the hospital census is near-capacity, either from insufficient physical beds or nurse staffing, discharge delays can result in postanesthesia care unit (PACU) congestion that backs up the operating rooms. Hospital administrators often promote increasing morning discharges as mitigation. Before the COVID-19 pandemic, most hospitalized Florida patients were discharged after 3 PM, without change from 2010 through 2018. The current study extended the observation period through 2022 to determine if discharge pressure during the COVID-19 pandemic from persistent high census resulted in overall earlier hospital discharges. Results showed the percentages of patients discharged by 12 noon or 3 PM remained unchanged. Among 1,034,515 discharges at 197 hospitals during the last 2 quarters of 2022, most discharges (P < 0.0001 versus 50%) occurred after 3 PM. The pooled incidence of discharges by noon was 13.2%, while the estimate of the incidence inverse weighted by the hospitals' counts of discharges was 13.3% (97.5% 12.6% to 14.1%). The corresponding pooled incidences of discharges by 3 PM was 42.5%, and 43.7% (97.5% confidence interval 42.3% to 45.2%). All 136,924 combinations of hospital and Medicare severity diagnosis-related groups were evaluated to examine why discharges did not occur earlier. Among the 1377 such combinations (1% of the total) with a significant change in median length of stay, 95% (1313) were decreases in lengths of stay. The implication is that the pandemic had no salutatory effect on earlier discharges. Therefore, post-anesthesia care unit managers should continue to plan for most hospital beds to be unavailable until late afternoon. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Medical Systems is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Most Weekday Discharge Times at Acute Care Hospitals in the State of Florida Occurred After&#160;3&#160;PM in 2022, Unchanged from Before the COVID-19 Pandemic.
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  Data: When the hospital census is near-capacity, either from insufficient physical beds or nurse staffing, discharge delays can result in postanesthesia care unit (PACU) congestion that backs up the operating rooms. Hospital administrators often promote increasing morning discharges as mitigation. Before the COVID-19 pandemic, most hospitalized Florida patients were discharged after 3 PM, without change from 2010 through 2018. The current study extended the observation period through 2022 to determine if discharge pressure during the COVID-19 pandemic from persistent high census resulted in overall earlier hospital discharges. Results showed the percentages of patients discharged by 12 noon or 3 PM remained unchanged. Among 1,034,515 discharges at 197 hospitals during the last 2 quarters of 2022, most discharges (P &lt; 0.0001 versus 50%) occurred after 3 PM. The pooled incidence of discharges by noon was 13.2%, while the estimate of the incidence inverse weighted by the hospitals&#39; counts of discharges was 13.3% (97.5% 12.6% to 14.1%). The corresponding pooled incidences of discharges by 3 PM was 42.5%, and 43.7% (97.5% confidence interval 42.3% to 45.2%). All 136,924 combinations of hospital and Medicare severity diagnosis-related groups were evaluated to examine why discharges did not occur earlier. Among the 1377 such combinations (1% of the total) with a significant change in median length of stay, 95% (1313) were decreases in lengths of stay. The implication is that the pandemic had no salutatory effect on earlier discharges. Therefore, post-anesthesia care unit managers should continue to plan for most hospital beds to be unavailable until late afternoon. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Journal of Medical Systems is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1007/s10916-025-02164-5
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      – Code: eng
        Text: English
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        PageCount: 6
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    Subjects:
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Data analysis
        Type: general
      – SubjectFull: Discharge planning
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Statistics
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      – SubjectFull: Confidence intervals
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      – SubjectFull: Length of stay in hospitals
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      – SubjectFull: Time
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      – SubjectFull: COVID-19 pandemic
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      – SubjectFull: Health care rationing
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      – SubjectFull: Florida
        Type: general
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      – TitleFull: Most Weekday Discharge Times at Acute Care Hospitals in the State of Florida Occurred After 3 PM in 2022, Unchanged from Before the COVID-19 Pandemic.
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              Text: 2/25/2025
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