Publication: Proportion and associated factors for delayed discharge in domiciliary patients in Kelantan
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Date
2025-06
Authors
Ismail, Mohd Fauzie
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Abstract
Background: Delayed discharge from domiciliary care services can impede patient transitions and strain healthcare resources, particularly in Malaysia’s primary healthcare system. Understanding its prevalence and contributing factors is crucial for optimizing care delivery in Malaysia.
Objectives: To determine the proportion of delayed discharges and identify associated demographic and clinical factors among domiciliary care services patients in Kelantan.
Methods: A cross-sectional study was conducted using retrospective data from the Domiciliary Care Patient’s Registry (PPD101) of the Kelantan State Health Department, covering patients registered from January 2023 to December 2024. Of 1494 registered patients, 828 met the inclusion criteria. Descriptive statistics, simple logistic regression, and multiple logistic regression were used to analyze and find significant factors associated with delayed discharge.
Results: The proportion of delayed discharge was 4.0%. Significant factors included health clinic referrals (Adjusted OR: 2.15; 95% CI: 1.32,3.50; p = 0.002), low pre-domiciliary Modified Barthel Index scores (Adjusted OR: 0.98; 95% CI: 0.97,0.99; p < 0.001), higher clinical care needs (Adjusted OR: 1.45; 95% CI: 1.20,1.75; p < 0.001), and increased domiciliary visit frequency (Adjusted OR: 1.12; 95% CI: 1.05,1.20; p = 0.001).
Conclusion: Delayed discharge affects a small but notable proportion of domiciliary patients in Kelantan. Targeted interventions, including enhanced care coordination and early functional assessment and early initialisation of tailored rehabilitation care are needed to address these factors and improve care efficiency.
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Keywords
Domiciliary care , delayed discharge