Glasby Jon, Littlechild Rosemary, Pryce Kathryn
Health Services Management Centre, University of Birmingham, Park House, 40 Edgbaston Park Road, Edgbaston, Birmingham B15 2RT, UK.
J Health Serv Res Policy. 2006 Jan;11(1):52-8. doi: 10.1258/135581906775094208.
Delayed hospital discharges are a key concern in a number of industrialized nations and are the subject of a range of government initiatives in the English National Health Service. The aim of this paper was to review the UK literature on delayed hospital discharges and older people in order to identify and explore the rate and causes of delayed hospital discharges, together with policies and practices that may reduce delayed discharges and improve the experiences of older people.
Literature review based on searches of major health/social-care databases. Sources which explore the rate and cause of delayed discharges in the UK were included. Relevant documents were categorized using the research hierarchy set out in the National Service Framework for Older People and analysed according to criteria for appraising the quality of qualitative research proposed by Mays et al.
The review identified 21 studies, which suggest very different rates and causes of delayed discharge in different settings. The studies reveal the importance of rehabilitation services to reduce the rate of delayed discharge, the prevalence of delayed discharges caused by internal hospital factors, and the complex and multi-faceted nature of the factors contributing to delayed discharge. Despite this, the studies have a number of methodological flaws and often fail to include a patient perspective or to consider detailed policies and approaches to reduce the number of delayed discharges. There is also a failure to consider the needs of older people with mental health problems or people from minority ethnic communities.
The evidence, as it currently stands, raises a number of issues about current hospital discharge policy, supporting some aspects of the current government agenda in England, but questioning other aspects.
延迟出院是许多工业化国家关注的重点问题，也是英国国民医疗服务体系一系列政府举措的主题。本文旨在回顾英国关于延迟出院与老年人的文献，以确定并探究延迟出院的发生率和原因，以及可能减少延迟出院并改善老年人体验的政策与实践。
基于对主要健康/社会护理数据库的检索进行文献综述。纳入探讨英国延迟出院发生率和原因的资料来源。相关文件根据《老年人国家服务框架》中规定的研究层次进行分类，并按照梅斯等人提出的定性研究质量评估标准进行分析。
该综述确定了21项研究，这些研究表明不同环境下延迟出院的发生率和原因差异很大。研究揭示了康复服务对于降低延迟出院发生率的重要性、医院内部因素导致延迟出院的普遍性，以及造成延迟出院的因素具有复杂性和多面性。尽管如此，这些研究存在一些方法上的缺陷，往往未纳入患者视角，也未考虑减少延迟出院数量的详细政策和方法。此外，也未考虑有心理健康问题的老年人或少数族裔社区人群的需求。
就目前情况而言，现有证据引发了一些关于当前医院出院政策的问题，支持了英国现任政府议程的某些方面，但也对其他方面提出了质疑。
