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Open Access

Factors associated with delays in discharge for trauma patients at an urban county hospital

Christopher Cai, Karla Lindquist, Tasce Bongiovanni
DOI: 10.1136/tsaco-2020-000535 Published 9 November 2020
Christopher Cai
1School of Medicine, University of California San Francisco, San Francisco, California, USA
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Karla Lindquist
2Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA
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Tasce Bongiovanni
3Department of Surgery, University of California San Francisco, San Francisco, California, USA
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    Figure 1

    Incidence rate ratios (IRRs) and 95% CIs are estimated from the count portion of a multivariable zero-inflated negative binomial regression model (all variables were included in the binary portion of the model). AMA, against medical advice; AWOL, absent without leave.

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  • Table 1

    Age, housing status, insurance and discharge location were associated with increased risk of delay in discharge

    All patientsPatients experiencing delay in dischargePatients experiencing no delay in dischargeP value*
    N (%)1720 (100)261 (15.2)1459 (84.8)
    Age in years,
    mean±SD
    49.6±19.055.4±18.548.5±18.9<0.001
    Gender, n %0.990
     Male1067 (62.0)162 (62.1)905 (62.0)
     Female653 (38.0)99 (37.9)554 (38.0)
     Other†0 (0)0 (0)0 (0)
    Ethnicity, n (%)0.058
     White444 (25.8)60 (23.0)384 (26.3)
     African-American225 (13.1)48 (18.4)177 (12.1)
     Asian329 (19.1)48 (18.4)281 (19.3)
     Hispanic652 (37.9)98 (37.5)554 (38.0)
     Other, incl Native American/Pacific Islander70 (4.1)7 (2.7)63 (4.3)
    Unhoused, n (%)<0.001
     Yes227 (13.2)60 (23.0)167 (11.4)
     No1459 (84.8)194 (74.3)1265 (86.7)
     Unknown34 (2.0)7 (2.7)27 (1.9)
    Lives in SF, no. (%)1237 (71.9)182 (69.7)1055 (72.3)0.393
    Insurance, n (%)<0.001
     Medi-Cal566 (32.9)101 (38.7)464 (31.8)
     San Franisco Health Plan (SFHP)365 (21.2)55 (21.1)310 (21.3)
     Medicare351 (20.4)67 (25.7)284 (19.5)
     Medicare+Medi Cal25 (1.5)13 (5.0)12 (0.8)
     Private319 (18.6)14 (5.4)305 (20.9)
     Self-pay22 (1.3)3 (1.2)19 (1.3)
     Worker’s comp41 (2.4)3 (1.2)38 (2.6)
     Other31 (1.8)5 (1.9)26 (1.8)
    Has primary care provider, n %719 (41.8)115 (44.1)604 (41.4)0.422
    Primary language English, n %1236 (71.9)188 (72.0)1048 (71.8)0.947
    Discharge location, n %<0.001
     Home1348 (78.4)173 (66.3)1175 (80.5)
     Postacute care facility124 (7.2)58 (22.2)66 (4.5)
     Other92 (5.4)10 (3.8)82 (5.6)
     AMA/AWOL60 (3.5)3 (1.1)57 (3.9)
     Died59 (3.4)7 (2.7)52 (3.6)
     Home health37 (2.2)10 (3.8)27 (1.9)
    • *P values were calculated using an unpaired t-test for continuous variables, and Pearson’s χ2 or Fisher’s exact test for categorical variables.

    • †Not included in statistical test.

    • AMA, against medical advice; AWOL, absent without leave; SF, San Francisco.

  • Table 2

    ORs and 95% CIs for patients the odds of experiencing delays in discharge, from univariate and multivariate logistic regression models

    UnivariateMultivariable
    OR95% CIOR95% CI
    Age1.021.01 to 1.031.021.01 to 1.03
    Ethnicity: whiteref
     African-American1.741.14 to 2.641.530.96 to 2.44
     Asian1.090.73 to 1.651.080.69 to 1.71
     Hispanic1.130.80 to 1.601.270.86 to 1.88
     Other0.710.31 to 1.630.820.35 to 1.93
    Unhoused: noref
     Yes2.341.68 to 3.262.451.68 to 3.59
     Unknown1.690.73 to 3.941.460.58 to 3.67
    Insurance: publicref
     Medicare1.170.85 to 1.610.560.36 to 0.88
     Private0.230.13 to 0.400.240.13 to 0.44
     Other1.260.78 to 2.031.140.67 to 1.93
    Discharge location: homeref
     AMA/AWOL0.360.11 to 1.150.270.08 to 0.87
     Long-term care5.974.05 to 8.796.364.11 to 9.85
     Home health2.521.20 to 5.292.751.26 to 6.00
     Died0.910.41 to 2.050.730.32 to 1.67
     Other0.830.42 to 1.631.060.52 to 2.18
    • Bold and italicized results are significant at p<0.05.

    • AMA, against medical advice; AWOL, absent without leave.

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Factors associated with delays in discharge for trauma patients at an urban county hospital
Christopher Cai, Karla Lindquist, Tasce Bongiovanni
Trauma Surg Acute Care Open Nov 2020, 5 (1) e000535; DOI: 10.1136/tsaco-2020-000535

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Factors associated with delays in discharge for trauma patients at an urban county hospital
Christopher Cai, Karla Lindquist, Tasce Bongiovanni
Trauma Surg Acute Care Open Nov 2020, 5 (1) e000535; DOI: 10.1136/tsaco-2020-000535
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Factors associated with delays in discharge for trauma patients at an urban county hospital
Christopher Cai, Karla Lindquist, Tasce Bongiovanni
Trauma Surgery & Acute Care Open Nov 2020, 5 (1) e000535; DOI: 10.1136/tsaco-2020-000535
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