Publication Date

2013

Document Type

Masters Thesis

Department

School for Social Work

Keywords

Children-Hospitals, Hospitals-Admission and discharge, Rehabilitation centers, Pediatric rehabilitation hospital, Stuck kids, Delayed discharge, Prolonged hospitalization, Unnecessary hospital days, Administrative days

Abstract

This study examined factors that contribute to medically complex children getting "stuck" in acute rehabilitation hospital level of care even though they were medically ready for discharge. Of special interest were caretaker and societal-related factors that may have a high potential for change and early intervention. Sample. Retrospective, non-comparative case series. Methods. The medical records of 20 children discharged between 2010 and 2012 from a specialty acute rehabilitation hospital in New England were surveyed using a protocol designed for the project. The children had been placed on "administrative days" (AD) prior to discharge. Univariate and bivariate analysis examined the impact of patient disease characteristics, parental characteristics, and societal factors on post-AD status length of stay. Findings. Although the final sample size (N=20) limited the reliability and types of statistical tests that could be undertaken, analysis suggested that disease factors interact with caretaker and societal factors to create the conditions that delay discharge. Findings from the study were used to inform the development of screening tools and targeted interventions for use by the Medical Social Work Service at the host hospital. And a recommendation was made to develop a prospective, comparative case series study of all admissions to further explore the factors identified in this pilot study.

Language

English

Comments

v, 56 p. Thesis (M.S.W.)--Smith College School for Social Work, 2013. Includes bibliographical references (p. 45-47)