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KMID : 0387320220320040347
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Korean Journal of Health Policy and Administration
2022 Volume.32 No. 4 p.347 ~ p.355
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A Multilevel Analysis about the Impact of Patient’s Willingness for Discharge on Successful Discharge from Long-term Care Hospitals
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Kang Ha-Ryeom
Lee Yeon-Ju
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Abstract
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Background: Since November 2019, long-term care hospitals have been able to provide patients with discharging programs tosupport the elderly in the community. This study aimed to identify both patient- and hospital-level factors that affect successfulcommunity discharge from long-term care hospitals.
Methods: A multilevel logistic regression model was performed using hospitals as a clustering unit. The dependent variable waswhether a patient stayed in the community for at least 30 days after discharge from a long-term care hospital. As for the patient-levelindependent variables, an agreement between a patient and the family about discharge, length of hospital stay, patient category, andresidence at discharge were included. The number of beds and the ratio of long-stay patients were selected for the hospital-levelfactors. The sample size was 1,428 patients enrolled in the discharging program from November 2019 to December 2020.
Results: The number of patients who were discharged to the community and stayed at least for 30 days was 532 (37.3%). Theintraclass correlation coefficient was 22.9%, indicating that hospital-level factors had a significant impact on successful communitydischarge. The odds ratio (OR) of successful community discharge increased by 1.842 times when the patients and their familiesagreed on discharge. The ORs also increased by 3.020 or 2.681 times, respectively when the patients planned to discharge to theirown house or their child’s house compared to those who didn’t have a plan for residence at discharge. The ORs increased by 1.922or 2.250 times when the hospitals were owned by corporate or private property compared to publicly owned hospitals. The ORsdecreased by 0.602 or 0.520 times when the hospital was sized over 400 beds or located in small and medium-sized cities comparedto less than 200 bedded hospitals or located in metropolitan cities.
Conclusion: The results of the study showed that the patients’ and their family’s willingness for discharge had a great impact onsuccessful community discharge and the hospital-level factors played a significant role in it. Therefore, it is important toacknowledge and support long-term care hospitals to involve active in the patient discharge planning process.
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KEYWORD
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Long-term care, Patient discharge, Multilevel analysis
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