Improving patient flow: ethnicity and socio-economic status associated with delayed discharge from hospital in patients with COVID-19 infection: An observational epidemiological study

Crooks, Colin; West, Joe; Gazis, Tasso; Morling, Joanne R; Simmonds, Mark; Juurlink, Irene; Briggs, Steve; Cruickshank, Simon; Hammond-Pears, Susan; Shaw, Dominick; Card, Timothy R; Fogarty, Andrew

Abstract

Background:
Understanding the reasons for delays in leaving hospital once an in-patient is considered ready for discharge is important to inform the development of interventions to improve patient flow through resource-stressed healthcare systems.

Aims:
To identify risk factors for delayed discharge from hospital during the COVID-19 pandemic.

Methods:
The study population was all patients admitted with COVID-19 infection from February 2020 to September 2021 to a large UK teaching hospital.

Results:
Data were available from 7929 admission events with a median delay of 0.20 days from being considered medically safe for discharge and the discharge date. Age older than 60 years (+2.23 days), White ethnicity (+1.58 days compared to SE Asian), living in an area of increased affluence (+0.13 days per decile decrease in deprivation) and having two or more comorbidities (+1.82 days; compared to no comorbidities) were associated with delayed discharge.
There was a total potential saving of over 22,000 bed-days if all patients had been discharged when they were considered medically safe.

Conclusions:
Early identification of patients at an increased risk of a delayed discharge may allow development of appropriate anticipatory interventions, and inform policymakers to help identify and minimise bottlenecks at the institutional level.

Citation

Crooks, C., West, J., Gazis, T., Morling, J. R., Simmonds, M., Juurlink, I., Briggs, S., Cruickshank, S., Hammond-Pears, S., Shaw, D., Card, T. R., & Fogarty, A. (2025). Improving patient flow: ethnicity and socio-economic status associated with delayed discharge from hospital in patients with COVID-19 infection: An observational epidemiological study. Journal of Research in Nursing, https://doi.org/10.1177/17449871241310384

• Journal Article Type: Article
• Acceptance Date: Dec 12, 2024
• Online Publication Date: Aug 29, 2025
• Publication Date: Aug 29, 2025
• Deposit Date: Jan 2, 2025
• Publicly Available Date: Jan 2, 2025
• Journal: Journal of Research in Nursing
• Print ISSN: 1744-9871
• Electronic ISSN: 1744-988X
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1177/17449871241310384
• Public URL: https://nottingham-repository.worktribe.com/output/43682222
• Publisher URL: https://journals.sagepub.com/doi/10.1177/17449871241310384