Two in five medical inpatients were ready to go home

Design

Multicentre cross-sectional survey on a single day

Population

1,348 general medicine inpatients in 21 VA hospitals

Primary outcome

Proportion medically ready for discharge; proportion ready ≥1 week

Effect

41.9% ready; 18.1% ready for ≥1 week

A one-day cross-sectional survey across 21 US veterans' hospitals, in the Journal of Hospital Medicine (15 October), asked attending physicians about 1,348 general medical inpatients.

42% were judged medically ready for discharge, ranging from 18% to 65% between hospitals. 18% had been ready for a week or longer. More than half of those with long delays were awaiting a nursing home or assisted-living place, and the main unmet needs were help with daily activities and geriatric-psychiatric care.

The setting is the US veterans' system, but the pattern — patients well enough to leave with nowhere to go — is familiar in any health system with stretched long-term care. Early identification of placement needs, from admission, is the lever available to ward teams.

• Ask about home support and likely destination on the day of admission
• Refer early for placement or social-care assessment when needs are obvious
• Track 'medically ready' days as a ward metric to see where delays sit
• Remember that prolonged stays carry deconditioning and infection risk

Why it matters

Delayed discharge is a safety problem for the patient, not only a bed problem for the hospital.

The statistics, in plain English

This is a single-day snapshot based on physicians' judgement, so it measures a point prevalence rather than how long the average patient waits.

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