Dementia and Delayed Hospital Discharges: Assessing the Post-Discharge Care Gap for Older Adults in Canada

In Canada, hospitalized patients aged 65 and older with dementia as a primary diagnosis often face delayed discharges due to limited access to long-term care (LTC) facilities and homecare services. This study compares patients aged 65 and older with dementia as the primary diagnosis to those with 16 broad categories of other primary diagnoses-excluding dementia-related conditions where applicable-across three key outcomes: (1) the likelihood of experiencing a delayed discharge, (2) the length of delay among those who experienced one, and (3) among delayed discharge patients, the likelihood of being discharged to one of three destinations-homecare, long-term care with 24-h nurse care (LTC-24), or other post-acute residential care (PARC), including rehabilitation, complex continuing care, group living, or supportive housing. Using 2023-24 data from the Discharge Abstract Database (DAD), this study applies logistic, negative binomial, and multinomial logit models. After adjusting for other factors, patients with primary diagnoses other than dementia were about 35% to 95% less likely to experience a delayed discharge, and when delays occurred, their expected duration was roughly 32% to 65% shorter. All estimates were statistically significant at the 1% level. Among patients who experienced delays, those with other primary diagnoses were also less likely to be discharged to homecare, PARC, or LTC-24 rather than home. These findings highlight the urgent need to expand access to specialized, affordable post-discharge care for patients with dementia, as their complex needs strain hospital capacity.