Hospital physicians' views on discharge and readmission processes: a qualitative study from Norway
Hospital physicians' views on discharge and readmission processes: a qualitative study from Norway
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DOI：
10.1136/bmjopen-2019-031297
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发表时间：
2019-08-01
期刊：
影响因子：
2.9
通讯作者：
Wiig, Siri
中科院分区：
文献类型：
--
作者：
Glette, Malin Knutsen;Kringeland, Tone;Wiig, Siri
目的探讨医院医师对医院与城市交界的再入院和出院流程的看法。设计定性案例研究。挪威的医疗保健系统。参与者来自一家医院的15名医院医生（住院医师和顾问），参与病人的治疗和出院。结果本研究的结果表明，患者出院时间比以前更早，病情更复杂，有时出院被认为是过早的。医院能力不足造成病人出院的压力，但该地区的初级保健服务并不总是能够照顾这些病人。各级医疗保健服务之间的通信有限。住院总结是各层级之间最重要的，有时也是唯一的沟通形式。出院过程被描述为复杂的，受到保健人员、病人本身和初级保健服务各方面的影响。早期出院、医疗保健服务之间沟通不畅以及出院过程中的不足被认为会影响再入院。结论本研究结果有助于更好地了解医院医生对医院与初级卫生保健服务界面中出院和再入院过程的看法。该研究还指出，在政府要求、改革条例以及市政当局和医院的现行做法方面存在差异。
Objectives To explore hospital physicians' views on readmission and discharge processes in the interface between hospitals and municipalities.Design Qualitative case study.Setting The Norwegian healthcare system.Participants Fifteen hospital physicians (residents and consultants) from one hospital, involved in the treatment and discharge of patients.Results The results of this study showed that patients were being discharged earlier, with more complex medical conditions, than they had been previously, and that discharges sometimes were perceived as premature. Insufficient capacity at the hospital resulted in pressure to discharge patients, but the primary healthcare service of the area was not always able to assume care of these patients. Communication between levels of the healthcare service was limited. The hospital stay summary was the most important, and sometimes only, form of communication between levels. The discharge process was described as complicated and was affected by healthcare personnel, by patients themselves and by aspects of the primary healthcare service. Early hospital discharges, poor communication between healthcare services and inadequacies in the discharge process were perceived to affect hospital readmissions.Conclusion The results of this study provide a better understanding of hospital physicians' views on the discharge and hospital readmission processes in the interface between the hospital and the primary healthcare service. The study also identifies discrepancies in governmental requirements, reform regulations and current practices in municipalities and hospitals.