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December 26, 2023

Backlog of patients waiting for discharge to worsen this winter, hospitals warn

Photo | Timothy Doyle UMass Memorial Medical Center's University campus, which is one of the hospitals in the UMass Memorial Health system.

The hefty backlog of patients waiting to be discharged from hospitals and transferred to other treatment settings is expected to grow this winter, health leaders warned Monday.

About 750 patients were stuck in acute or post-acute care hospitals on any given day in November as they waited to receive additional care at skilled nursing or rehabilitation facilities, as well as from home health agencies, according to the latest throughput report from the Massachusetts Health and Hospital Association. Just over 200 patients waited 30 days or longer to be discharged to a skilled nursing facility, MHA said.

"Based on data trends, the backups are expected to worsen in the coming months," MHA wrote in its weekly newsletter. "The December 2022 to March 2023 winter totals, taken from a smaller sample of hospitals during the height of flu/COVID/RSV season, showed the numbers of patients stuck in acute hospitals beds totaling more than 1,000 per month."

State public health data show that about 16 percent of the roughly 67,200 emergency department visits from Dec. 10-16 were tied to acute respiratory disease.

The hospital backlogs are caused by obstacles including administrative barriers from insurance companies, inadequate insurance coverage, and staffing and capacity constraints at post-acute care facilities, MHA said.

The association described the backups as a "persistent problem" in the state's health care system that "remains unresolved," even as hospitals try to find solutions like coordinating admissions with skilled nursing facilities over the weekends.

"Hospitals and their partners across the post-acute care continuum are also strengthening hospital-to-home programs, seeking additional reimbursement for MassHealth patients who need specialized post-acute care, addressing the challenges of patients with psychiatric diagnoses who require skilled nursing facility care, and working to highlight the need to recruit more individuals to serve in roles of guardians and conservators for patients who require assistance with decision-making needs," MHA said. "Caregiver shortages are also a great problem that the healthcare system hopes to further address in 2024."

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