Real-life implementation of guidelines on the hospital-to-home transition for older patients: a cohort study in general practice.
aged
continuity of patient care
general practice
older people
patient discharge
patient readmission
Journal
Age and ageing
ISSN: 1468-2834
Titre abrégé: Age Ageing
Pays: England
ID NLM: 0375655
Informations de publication
Date de publication:
01 12 2019
01 12 2019
Historique:
received:
01
03
2019
pubmed:
26
11
2019
medline:
22
9
2020
entrez:
26
11
2019
Statut:
ppublish
Résumé
hospital discharge is a critical event for older patients. The French guidelines recommended the swift transmission of a discharge summary to the general practitioner (GP) and a primary care consultation within 7 days. The relevance and feasibility of these guidelines have not previously been assessed. to perform a real-life assessment of compliance with French guidelines on the transmission of discharge summaries and post-discharge medical reviews and to examine these factors' association with 30-day readmissions. a prospective multicentre cohort study. primary care (general practice) in France. a sample of GPs and the same number of patients aged 75 or over having consulted within 30 days of hospital discharge. the main endpoints were the proportion of discharge summaries available and the proportion of patients consulting their GP within 7 days. The 30-day readmission rate was also measured. Factors associated with these endpoints were assessed in univariate and multivariate analyses. seventy-one GPs (mean ± standard deviation age: 49 ± 11; males: 62%) and 71 patients (mean age: 84 ± 5; males: 52%; living at home: 94%; cognitive disorders: 22%) were included. Forty-six patients (65%, [95% confidence interval [CI]]: 53-76) consulted their GP within 7 days of hospital discharge. At the time of the consultation, 27 GPs (38% [95% CI]: 27-50) had not received the corresponding hospital discharge summary. Discharge summary availability was associated with a lower risk of 30-day readmission (adjusted odds ratio [95% CI] = 0.25 [0.07-0.91]). compliance with the French guidelines on hospital-to-home transitions is insufficient.
Sections du résumé
BACKGROUND
hospital discharge is a critical event for older patients. The French guidelines recommended the swift transmission of a discharge summary to the general practitioner (GP) and a primary care consultation within 7 days. The relevance and feasibility of these guidelines have not previously been assessed.
OBJECTIVE
to perform a real-life assessment of compliance with French guidelines on the transmission of discharge summaries and post-discharge medical reviews and to examine these factors' association with 30-day readmissions.
DESIGN
a prospective multicentre cohort study.
SETTING
primary care (general practice) in France.
SUBJECTS
a sample of GPs and the same number of patients aged 75 or over having consulted within 30 days of hospital discharge.
METHODS
the main endpoints were the proportion of discharge summaries available and the proportion of patients consulting their GP within 7 days. The 30-day readmission rate was also measured. Factors associated with these endpoints were assessed in univariate and multivariate analyses.
RESULTS
seventy-one GPs (mean ± standard deviation age: 49 ± 11; males: 62%) and 71 patients (mean age: 84 ± 5; males: 52%; living at home: 94%; cognitive disorders: 22%) were included. Forty-six patients (65%, [95% confidence interval [CI]]: 53-76) consulted their GP within 7 days of hospital discharge. At the time of the consultation, 27 GPs (38% [95% CI]: 27-50) had not received the corresponding hospital discharge summary. Discharge summary availability was associated with a lower risk of 30-day readmission (adjusted odds ratio [95% CI] = 0.25 [0.07-0.91]).
CONCLUSIONS
compliance with the French guidelines on hospital-to-home transitions is insufficient.
Identifiants
pubmed: 31763676
pii: 5639747
doi: 10.1093/ageing/afz143
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
46-51Informations de copyright
© The Author(s) 2019. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.