Patients with high ESDP scores had more problems after discharge (p=0.02), lower quality of life (p<0.001), longer stays (p=0.04), and higher post-acute care use (p=0.006) than those with low scores.
Observational (n=222)
No
Does a high ESDP score predict post-discharge problems, lower quality of life, longer length of stay, and use of post-acute care services in patients admitted to a rural regional community hospital?
The Early Screen for Discharge Planning (ESDP) tool effectively identifies patients at risk for post-discharge problems and higher resource utilization in a rural community hospital setting.
PURPOSE OF STUDY: The Early Screen for Discharge Planning (ESDP) is a decision support tool developed in an urban academic medical center. High ESDP scores identify patients with nonroutine discharge plans who would benefit from early discharge planning intervention. We aimed to determine the predictive performance of the ESDP in a different practice setting. PRIMARY PRACTICE SETTING: Rural regional community hospital. METHODOLOGY AND SAMPLE: We designed a comparative, descriptive survey study and enrolled a convenience sample of 222 patients (identified at admission) who provided informed consent. Sample characteristics and ESDP scores were collected during enrollment. The Problems After Discharge Questionnaire, EuroQoL-5Dimensions quality-of-life measure, length of stay, and use of post-acute care services were recorded after discharge. We compared outcomes between patients with low and high ESDP scores. RESULTS: More than half of the sample (51.8%) had a high ESDP score. Patients with high ESDP scores reported more problems after discharge (p = .02), reported lower quality of life (p < .001), had longer length of stays (p = .04), and used post-acute care services (p = .006) more than patients with low ESDP scores. The difference in the average percentage of unmet needs was not statistically significant (p = .12), but patients with high ESDP scores reported more unmet needs than patients with low ESDP scores. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: The value of systematically proactive approaches to discharge planning is increasingly recognized, but establishing the performance capacity of support tools is critical for optimizing benefit. These study findings support use of the ESDP in regional community hospitals, making it a useful, open-source decision support tool for various health care delivery systems.
Holland et al. (Thu,) conducted a observational in Hospital admission (n=222). High Early Screen for Discharge Planning (ESDP) score vs. Low ESDP score was evaluated on Problems after discharge, quality of life, length of stay, and use of post-acute care services. Patients with high ESDP scores had more problems after discharge (p=0.02), lower quality of life (p<0.001), longer stays (p=0.04), and higher post-acute care use (p=0.006) than those with low scores.