Measuring outcome after discharge from hospital for the elderly--a conceptual and empirical investigation.
Despite the fact that the elderly are a major client group of the hospital service, there has been comparatively little investigation of outcome for this client group after discharge. In this paper the difficulties in recording outcome for the elderly are discussed, using the example of a survey based in Wales. A 4% random sample of patients aged 65 years and over discharged from NHS non-psychiatric hospitals in Wales during 1981 were sent a postal questionnaire 3 months after discharge. Response rates of over 80% were achieved. Outcome after discharge was measured by 3 indices: mortality, physical disability, and patients' own assessments of their health status and rehabilitation. Of survivors, 35% were more disabled than before admission, and 43% did not feel that they were fully rehabilitated. All measures of outcome were strongly inter-correlated and demonstrate a clear trend to deteriorate with increased time after discharge. Interpretation of these results remains difficult until measures of cost and benefit are developed. Without these it is not possible to determine if the results reported are better (or worse) than would be expected given the level of resources involved.
Victor
C R
CR
Research Team for Care of the Elderly, University of Wales College of Medicine, St. Davids Hospital, Cardiff, UK.
Vetter
N J
NJ
D000203:Activities of Daily Living; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010043:Outcome and Process Assessment, Health Care; D010351:Patient Discharge; D012494:Sampling Studies; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D014852:Wales