{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:50:37Z","timestamp":1792180237991,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,12,12]],"date-time":"2017-12-12T00:00:00Z","timestamp":1513036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>In the English National Health Service there is an increasing interest in understanding the factors associated with delayed discharges in older hospitalized adults. The present study sought to analyze whether clinical frailty was a significant and independent risk factor for having a delayed discharge when the data were controlled for potential health and social confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective observational study in an English National Health Service teaching hospital. We analyzed all first hospitalization episodes to the Department of Medicine for the Elderly between 1 May 2016 and 31 July 2016. A delayed discharge was operationally defined as a patient being discharged more than 24 h after his\/her last recorded clinically fit date.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 924 cases were analyzed. The independent risk factors for having a delayed discharge were: needing a new package of care (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 4.05, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.68\u20136.10), new institutionalization (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.78, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>:1.67\u20134.62), living alone (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.98, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.40\u20132.81), delirium (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.79, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.17\u20132.74) and frailty (i.e. \u22655 on the Clinical Frailty Scale, <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.74, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.15\u20132.63).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present results are consistent with previous reports that delayed discharges in older hospitalized patients are mainly related to new formal social care requirements in survivors of acute illness. Frailty was an independent risk factor for delay, but its effect might have been confounded by the unmeasured variable of informal care requirements. Our operational definition of delayed discharge does not mirror the legal definition of delayed transfer of care in England, and the results are not externally valid. <jats:bold>Geriatr Gerontol Int 2018; 18: 530\u2013537<\/jats:bold>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ggi.13212","type":"journal-article","created":{"date-parts":[[2017,12,12]],"date-time":"2017-12-12T09:57:52Z","timestamp":1513072672000},"page":"530-537","source":"Crossref","is-referenced-by-count":35,"title":["Health and social factors associated with a delayed discharge amongst inpatients in acute geriatric wards: A retrospective observational study"],"prefix":"10.1111","volume":"18","author":[{"given":"George","family":"Moore","sequence":"first","affiliation":[{"name":"School of Clinical Medicine University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1033-5897","authenticated-orcid":false,"given":"Peter","family":"Hartley","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Addenbrooke's Hospital Cambridge University Hospitals NHS Foundation Trust  Cambridge UK"},{"name":"Primary Care Unit, Department of Public Health and Primary Care University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3882-7447","authenticated-orcid":false,"given":"Roman","family":"Romero\u2010Ortuno","sequence":"additional","affiliation":[{"name":"Department of Medicine for the Elderly, Addenbrooke's Hospital Cambridge University Hospitals NHS Foundation Trust  Cambridge UK"},{"name":"Clinical Gerontology Unit, Department of Public Health and Primary Care University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)62167-9"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2015-206978"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13193"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.12827"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/cks171"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.7748\/ns.31.29.22.s23"},{"key":"e_1_2_7_8_1","volume-title":"Social Care for Older People: Home Truths","author":"Humphries R","year":"2016"},{"key":"e_1_2_7_9_1","volume-title":"Testing the Bed\u2010Blocking Hypothesis: Does Higher Supply of Nursing and Care Homes Reduce Delayed Hospital Discharges?","author":"Gaughan J","year":"2014"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcv066"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.12788\/jhm.2685"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.050051"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2016.08.033"},{"key":"e_1_2_7_15_1","volume-title":"Delayed Discharges Definitions and Data Recording Manual","author":"Scotland NNS","year":"2012"},{"key":"e_1_2_7_16_1","doi-asserted-by":"crossref","unstructured":"Legislation.gov.uk. The care and support (discharge of hospital patients) regulations. 2014. [Cited 2 Nov 2017.] Available from URL:https:\/\/www.legislation.gov.uk\/uksi\/2014\/2823\/contents\/made","DOI":"10.22233\/20412495.0814.4"},{"key":"e_1_2_7_17_1","unstructured":"NHS England. Delayed transfers of care data and guidance. [Cited 2 Nov 2017.] Available from URL:https:\/\/www.england.nhs.uk\/statistics\/statistical-work-areas\/delayed-transfers-of-care\/"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0594.2012.00847.x"},{"key":"e_1_2_7_19_1","unstructured":"Cambridge University Hospitals. Cambridge University Hospitals NHS Foundation Trust: annual report and accounts 2016\/2017.2017. Available from URL:https:\/\/www.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/634098\/CAMBRIDGE__Annual_Report_and_Accounts_2016-17.pdf"},{"key":"e_1_2_7_20_1","unstructured":"National Audit Office. 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