Forced prolonged hospital stays as a manifestation of the dysfunction of the Polish long-term care system

Background
Long-term care (LTC ) services involve long-lasting continuous supervision, care, nursing, therapy, and rehabilitation of patients who do not qualify for acute medical care. Demand for LTC services is on the rise, because of the aging of society and increasing number of dependent young and middle-aged people.

Objectives
The aim of the study was to examine the dysfunction of LTC services in Poland, taking the phenomenon of prolonged hospitalization as an example.

Material and methods
We examined data on patients at the University Clinical Hospital in Wroclaw, Poland, who were waiting for transfer from hospital to LTC facilities in the years 2012–2017. The statistical threshold of significance was p < 0.05.

Results
There were 1006 cases of hospital stays prolonged by waiting for transfer to LTC facilities; 77% of patients affected were 65 years or older. This age group saw a large increase in the total number of patients transferred from hospital to LTC facilities. Patients 65 years and older made up the majority of patients on transfer waiting lists, but their average waiting time was significantly shorter than that of younger patients (38.7 vs 69.6 days, respectively).

Conclusions
The demonstrated forced prolonged hospitalizations, which result from a lack of capacity on the part of LTC facilities to accept patients who have undergone hospital treatment, confirmed the dysfunction of the Polish LTC system. This results in a lack of adequate medical care continuity, increased total costs of medical care, and a shifting of expenses from the LTC facilities to the acute treatment facilities, which are most often hospitals.