Breaking the Bottleneck: Investigating Delayed Discharges and Their Impact on Healthcare Efficiency in a Small European Acute General Hospital

Delayed discharge represents a persistent challenge in healthcare systems, contributing to inefficiencies in hospital bed utilization, increased costs, and reduced patient flow. In small and centralized healthcare systems, these effects may be further amplified due to limited post-acute care capacity and restricted patient redistribution. This study quantified the prevalence of inappropriate hospital days as a proxy for delayed discharge and examined their relationship with patient demographics, medical specialty, and associated costs in an acute general hospital. A quantitative retrospective analysis of 220 medical records was conducted using a modified Appropriateness Evaluation Protocol (AEP). Descriptive statistics and non-parametric tests were applied to identify significant associations between inappropriate hospital days and selected variables. The results showed that approximately 50% of inpatient days were inappropriate, with most delays attributed to waiting for long-term care and rehabilitation placement. Age and medical specialty were significantly associated with delayed discharge, while no consistent relationship was observed with gender. Cost analysis indicated a substantial financial burden, with annual estimates exceeding €2.5 million for the units studied. These findings suggest that delayed discharge is driven by a combination of external capacity constraints and internal operational inefficiencies. The study highlights the need to strengthen post-acute care provision, improve discharge coordination processes, and enhance system integration to optimize hospital efficiency and patient flow.