Abstract
Intermediate care is an organisational approach to improve the coordination of health care services between health care levels. In Central Norway an intermediate care hospital was established in a municipality to improve discharge from a general hospital to primary health care. The aim of this study was to investigate how health professionals experienced hospital discharge of elderly patients to primary health care with and without an intermediate care hospital. A qualitative study with data collected through semi-structured focus groups and individual interviews. Discharge via the intermediate care hospital was contrasted favourably compared to discharge directly from hospital to primary health care. Although increased capacity to receive patients from hospital and prepare them for discharge to primary health care was viewed as a benefit, professionals still requested better communication with the preceding care level concerning further treatment and care for the elderly patients. The intermediate care hospital reduced the coordination challenges during discharge of elderly patients from hospital to primary health care. Nevertheless, the intermediate care was experienced more like an extension of hospital than an included part of primary health care and did not meet the need for communication across care levels.
Highlights
Intermediate care is an organisational approach to improve the coordination of health care services between health care levels
Integrated discharge pathways for elderly patients can be achieved in various ways: Discharge arrangements range from hospital-based teams [19], care pathways across hospital and primary health care [20,21], to interventions within primary health care to improve discharge support [22]
The aim of the study was to investigate how professionals across health care levels experience the discharge of elderly patients, who are in need of continued care, from a general hospital via an intermediate care hospital compared to a direct discharge to primary health care in a municipality without intermediate care
Summary
Intermediate care is an organisational approach to improve the coordination of health care services between health care levels. The aim of this study was to investigate how health professionals experienced hospital discharge of elderly patients to primary health care with and without an intermediate care hospital. Conclusions: The intermediate care hospital reduced the coordination challenges during discharge of elderly patients from hospital to primary health care. Integrated care strategies can be defined as techniques and organisational models designed to create connectivity, alignment and collaboration within and between the cure and the care sectors [17] Different concepts such as transitional care [4], care pathways and integrated care pathways [18] are used for the approach to strengthen coordination of health care services when patents transfer between different locations, providers or levels of care. Multidisciplinary approach, education, medical reconciliation and comprehensive transitional care programmes are other identified features of success [24]
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