Barriers to primary care hospital follow-up among older adults in rural or semi-rural communities

Abstract

BackgroundFailure to follow-up with a primary care provider (PCP) following discharge from an acute care setting is strongly associated with readmission within 90days among elderly patients. AimThe purpose of this study was to identify barriers to primary care follow-up among older adults in rural communities. MethodsThis was an explanatory mixed methods study which included scaled survey and interview techniques. Descriptive and inferential statistics were calculated for scaled concepts. Standard content analysis was performed on the qualitative items. ResultsCorrelation between intention to follow-up with a PCP and actual follow-up was poor (r=0.20). Patients encountered substantial obstacles to the PCP follow-up visit. Obstacles clustered into two groups: 1) healthcare or social system barriers and 2) personal characteristics of patients. ConclusionsIndividualized discharge planning that reflects the complexities of post-hospitalization adaptation for elders is most likely to be useful for ensuring PCP follow-up.