From hospital to post-acute care organizations: the relationship between patient experience and health recovery.

Generosa Do Nascimento,Janet E Anderson,Francisco Guilherme Nunes

doi:10.1093/intqhc/mzaa095

Abstract

To determine to what extent patient health status and recovery in post-acute care organizations (PACO) is related to patient experience of the discharge process from hospital and to patient experience while staying in these facilities. Longitudinal study of patients discharged from hospitals to PACO. 12 hospitals and 14 PACO Portuguese organizations. 181 patients participated in the both stages of data gathering. Patients' physical and mental health status was measured through the 36-item short form health survey scale. The experience of transition from hospital to PACO was measured with the Care Transition Measure. The Picker Adult In-Patient Questionnaire was used to measure patients' experience in these organizations. Patients reporting better physical condition in PACO had a better experience on discharge [b = 0.21, 95% confidence interval, CI (0.10, 0.31)] and perceive fewer problems inside facilities [b = - 0.19, 95% CI (-0.31, 0.08)]. The experience in PACO is significantly related to patients' mental health status [b = - 0.47, 95% CI (-0.59, - 0.36)]. Patients showing higher levels of physical recovery had a better experience on discharge [b = - 0.18, 95% CI (0.08, 0.28)], while those registering better mental recovery experienced fewer problems during their stay [b = - 0.41, 95% CI (-0.52, - 0.30)]. PACO play a key role in maintaining and promoting patients' health, and this goal is influenced by their experience both in the transition from hospitals to PACO and while staying in these facilities.

Highlights

Efforts to contain costs have led to shorter stays in hospital and higher numbers of patients being discharged to post acute care organisations to promote physical function and independence
This paper addresses the following research questions: 1- to what extent is patient experience of the discharge process from hospitals to post-acute care organizations (PACO) related to patient health status and recovery? 2- to what extent is patient experience while staying in PACO related to patient health status and recovery?
In this study we investigated the relationships between patient experience of discharge from hospitals to PACO and during their stay in these care organisations with patients’ mental and physical health

Summary

Introduction

Efforts to contain costs have led to shorter stays in hospital and higher numbers of patients being discharged to post acute care organisations to promote physical function and independence. Patients discharged from hospital to PACO are mainly older, female, functionally dependent, and often have a diagnosis of dementia [1]. Hospitalization itself, especially if prolonged, contributes to functional decline and deterioration of self-care abilities [2], which calls for transition to health maintaining or recovery-oriented units. These organizations are named differently across the world, and in this paper, we use the generic label of post-acute care organizations (PACO) acknowledging that the mix of services provided can vary from short term recovery and rehabilitation to long term care. The investment in long-term care has risen in most European countries. Transitions between different health care sites are common events in patients’ pathways, and management of discharges and the continuity of care is relevant for patient health and recovery

Objectives

Methods

Results

Conclusion