BARRIERS TO OUT-OF-HOSPITAL CARE FOR AIDS PATIENTS

In appropriate delays in hospital discharge for AIDS patients add to t he expense of health care, as well as to the stress felt by the patien t. It has been postulated that delays are due to a lack of suitable ou t-of-hospital services and weak patient support networks. The charts o f AIDS patients discharged from hospitals in northern New Jersey and s outhern New Jersey/Philadelphia, PA between 3/88 and 1/90 (n = 601 dis charges for 454 patients) were examined to determine the discharge ser vices or goods which were ordered and/or received, the extent of actua l delay, and the causes of these delays. While regional variations wer e evident, differences in the profession of the discharge planner were associated with having care ordered and received and delays in discha rge; as were availability of a support system, presence of a case mana ger, and race. A nurse or a social worker (as compared to a doctor as discharge planner) were more likely to effectively order and arrange o ut-of-hospital care, and were thus more likely to experience delays in hospital discharge. Failures of physicians to make timely requests fo r care were also associated with delays. Recommendations for future re search were made.