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Table 1 Main critical features in the discharge of 20 patients hospitalised for at least 35 days in a nephrology ward

From: Why are hospitalisations too long? A simple checklist for identifying the main social barriers to hospital discharge from a nephrology ward

Comorbidity- risk factor

Prevalence

Age > =75 years

90% (18/20)

Hospitalisation in multiple hospital wards

75% (15/20)

At least one severe comorbidity

75% (15/20)

Charlson Index

8 (6–13)

Complications during hospitalisation

70% (14/20)

Need for dialysis or dialysis dependence

40% (8/20)

Social factor/s delaying hospital discharge for > 1 week

25% (5/20)

  1. Note: analysis of the 20 longest hospital stays observed in 2017 in a 16-bed nephrology unit in the 1750-bed hospital, in Le Mans, France. The hospital serves a catchment area with about 300,000 inhabitants and its nephrology beds are the only ones available in an area with approximately 700,000 inhabitants. The centre has daily outpatient consultations (about 3000 in 2017) and an active day hospital in which 350 patients were treated in 2017
  2. The principal social problems which delayed discharge: difficulties involved in return to family (patient “too heavy”, dependent, bedridden..); lack of institutional solution (no availability of downstream beds); problems connected to dialysis (transport costs, clinical complexity); insufficient cooperation with geriatricians (overworked teams)