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52/100

✓ Peer-reviewed alzhub usefulness score 52 out of 100. Digital health tools

Topic: Risk, prevention and care in population studies

Background Hospitalized patients are designated alternate level of care (ALC) when they no longer require hospitalization but discharge is delayed while they await alternate disposition or living arrangements. We assessed hospital costs and complications for general internal medicine (GIM) inpatients who had delayed discharge. In addition, we developed a clinical prediction rule to identify patients at risk for delayed discharge. Methods We conducted a retrospective cohort study of consecutive GIM patients admitted between 1 January 2015 and 1 January 2016 at a large tertiary care hospital in Canada. We compared hospital costs and complications between ALC and non-ALC patients. We derived a clinical prediction rule for ALC designation using a logistic regression model and validated its diagnostic properties. Results Of 4311 GIM admissions, 255 (6%) patients were designated ALC. Compared to non-ALC patients, ALC patients had longer median length of stay (30.85 vs. 3.95 days p =80 years, female sex, dementia, diabetes with complications as well as referrals to physiotherapy, occupational therapy and speech language pathology. A clinical prediction rule that assigned each of these predictors 1 point had likelihood ratios for ALC designation of 0.07, 0.25, 0.66, 1.48, 6.07, 17.13 and 21.85 for patients with 0, 1, 2, 3, 4, 5, and 6 points respectively in the validation cohort. Conclusions Delayed discharge is associated with higher hospital costs and complication rates especially nosocomial infections. A clinical prediction rule can identify patients at risk for delayed discharge.

Key findings

Results Of 4311 GIM admissions, 255 (6%) patients were designated ALC.
Compared to non-ALC patients, ALC patients had longer median length of stay (30.85 vs. 3.95 days p =80 years, female sex, dementia, diabetes with complications as well as referrals to physiotherapy, occupational therapy and speech language pathology.
Conclusions Delayed discharge is associated with higher hospital costs and complication rates especially nosocomial infections.

Why it matters

This retrospective cohort study found that delayed hospital discharge was associated with higher hospital costs and complication rates, and that dementia was among the predictors of delayed discharge. It concerns hospital discharge planning and costs, not the treatment, cure or prevention of Alzheimer's disease.

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Study details

Study designcohort study
Evidence strengthModerate

How this study scored 52/100

Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (BMC health services research)
Journal's citation record	2 / 4	BMC Health Services Research: journal h-index 218 (OpenAlex, 2026-10-29)
Study design	7 / 12	A cohort study following people over time
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	2 / 5	2019 — within 10 year(s) of the newest study here
Sample size	0 / 4	Participant count not stated — scores zero (not stated in the record — scored 0)
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	0 / 3	Not stated whether this was studied in people — scores zero (not stated in the record — scored 0)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	4 / 7	Cited 79 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	8.8 citations a year over 9 year(s) since 2019
Impact for its field and year	3 / 6	Cited 6.8× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	0 / 6	No other study in this library cites it
Still being cited	2 / 4	Cited 45 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	3 / 4	Last-listed author Sudeep S. Gill: h-index 53 (OpenAlex, whole career)
Institution's track record	1 / 3	Queen's University: institution h-index 794 (OpenAlex)
Multi-centre collaboration	1 / 3	OpenAlex lists 3 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 31801590)
Free to read	2 / 2	Free to read
Total	52 / 100	—

What each of these 20 components measures, and what this score is not →

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Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.

APA 7th

Bai, A. D., Dai, C., Srivastava, S., Smith, C. A., & Gill, S. S. (2019). Risk factors, costs and complications of delayed hospital discharge from internal medicine wards at a Canadian academic medical centre: retrospective cohort study. BMC health services research. https://doi.org/10.1186/s12913-019-4760-3

Vancouver

Bai AD, Dai C, Srivastava S, Smith CA, Gill SS. Risk factors, costs and complications of delayed hospital discharge from internal medicine wards at a Canadian academic medical centre: retrospective cohort study. BMC health services research. 2019. doi:10.1186/s12913-019-4760-3. PMID: 31801590.

BibTeX

@article{bai2019-31801590,
  author  = {Bai, A. D. and Dai, C. and Srivastava, S. and Smith, C. A. and Gill, S. S.},
  title   = {{Risk factors, costs and complications of delayed hospital discharge from internal medicine wards at a Canadian academic medical centre: retrospective cohort study}},
  journal = {BMC health services research},
  year    = {2019},
  doi     = {10.1186/s12913-019-4760-3},
  pmid    = {31801590},
  url     = {https://doi.org/10.1186/s12913-019-4760-3}
}

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