February 21, 2023
1,115 patients impacted, 60,000 delay days: Data collection pilot begins to illustrate scope of complex case discharge delays in New York state
52 hospitals voluntarily reported on patients experiencing discharge delays between April and June 2022.
Rensselaer, NY, Feb. 21, 2023 – Results of a spring 2022 data collection pilot by the Healthcare Association of New York State demonstrate the tremendous consequences of the healthcare system’s gaps in care for individuals with complex care needs, which are leading to unnecessary long-term boarding in hospital inpatient units and emergency departments.
HANYS’ data collection pilot sought to estimate the number of patients who, for circumstances largely outside hospitals’ control, were unable to be safely discharged and spent more than four avoidable days in the emergency department and/or more than 14 avoidable days in an inpatient unit between April 1 and June 30, 2022. The pilot also collected data on the length of these complex case discharge delays, why they are occurring and who is most likely to be impacted.
For the three-month data collection period, 52 participating New York hospitals reported:
- 1,115 patients impacted;
- approximately 60,000 delay days;
- an average ED discharge delay of close to two weeks;
- an average hospital inpatient unit discharge delay of two months; and
- $169 million in estimated associated costs (for much of which hospitals receive no reimbursement).
Children and older adults living with medically complex and/or behavioral health conditions experienced the most frequent and longest delays. Delays reported were overwhelmingly due to an absence of post-discharge care options, followed by a lack of insurance coverage or means to pay for post-discharge care, and extended administrative processes, such as state and local agency referrals and determining eligibility for services and benefits.
These results illustrate the extraordinary scope of the complex case discharge delay problem, an issue that is a longstanding and growing challenge in New York, across the nation and throughout the world. The 52 reporting hospitals represent only a subset of New York’s total hospitals, with the three-month data collection period reflecting only a sample of the patients experiencing discharge delays that often last weeks, months – and sometimes a year or more.
“These numbers are astounding, and they only represent a sliver of the crisis,” said Bea Grause, RN, JD, president, HANYS. “The current system is failing thousands of patients annually, their loved ones and hospitals’ healthcare professionals who, despite their best efforts and intentions, lack the resources and robust system needed to ensure these individuals are in the most appropriate care setting for their unique needs.”
HANYS’ new report shares the association’s framework for change, focusing on four priority areas:
- preventing unnecessary hospital visits and discharge delays due to limited care options;
- intervening early when delays occur;
- responding to patient needs during unavoidable extended discharge delays; and
- increasing visibility of this issue.
HANYS continues to convene relevant parties, offer expertise in setting policy, strengthen relationships and share best practices to achieve better patient outcomes. The healthcare system must be designed for individuals with these care needs as the expectation, not the exception. The need for change is urgent.
The Healthcare Association of New York State is New York's statewide hospital and continuing care association, representing nonprofit and public hospitals, nursing homes, home care agencies and other healthcare organizations. HANYS is a nonprofit organization whose mission is to advance the health of individuals and communities by providing leadership, representation and service to healthcare providers and systems across the entire continuum of care.