Implementation of discharge plans for chronically ill elders discharged home.
Although discharge plans are viewed as the primary means to ensure that patients' needs will be met in the posthospital environment, little is known about the implementation of arranged care. This study addressed the extent to which discharge plans for elderly patients with congestive heart failure were implemented as planned, tested the consequences of implementation problems, and identified factors associated with implementation problems. For 40 percent of patients, one or more components of the discharge plan were not implemented as planned, with discrepancies more likely among low-income patients. Implementation discrepancies had negative consequences in terms of unmet needs, deficient quantity of help, and less than adequate care. Implications for hospital discharge planners and home health care are discussed.
Proctor
E K
EK
Center for Mental Health Services Research, George Warren Brown School of Social Work, Washington University, St. Louis, MO 63130, USA.
Morrow-Howell
N
N
Kaplan
S J
SJ
D000203:Activities of Daily Living; D000368:Aged; D003266:Continuity of Patient Care / Q000592:standards*; D005260:Female; D015577:Geriatric Assessment; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D010351:Patient Discharge / Q000592:standards*; D011446:Prospective Studies; D012044:Regression Analysis; D012948:Social Work Department, Hospital; D011795:Surveys and Questionnaires