title: Professionals and post-hospital care for older people.
abstract: Hospital elderly care teams in England assess whether patients need assistance, such as community or residential care, upon discharge from hospital. Does the type of multidisciplinary team influence post-hospital care decisions? The aim of this study was to identify which factors predict the services that older people receive upon discharge from hospital. Three multidisciplinary teams were compared where different professionals took the lead in co-ordinating the care assessment process. Data were collected in a case note review of patients (n = 456) aged 75 years and over: patient characteristics, referral patterns, and the types of service received in the month after leaving hospital. Multivariate statistical analysis (controlling for patient characteristics) showed different predictors for different post-hospital services. The nurse-led team was least likely to refer patients for care assessment and these patients received the least post-hospital services. The occupational therapy-led team arranged the most occupational therapy services and equipment and their patients received the most home care. The social work-led team referred the most patients for care assessment and their patients received the greatest range but not the greatest amount of services. These results suggest that multidisciplinary team configurations influence post-hospital services for older patients, reflecting professional preoccupations as much as patient care needs.
authors.affiliation: European Observatory for Health Care Systems, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK. judith.healy@lshtm.ac.uk
authors.forename: Judith
authors.initials: J
authors.lastname: Healy
authors.forename: Christina R
authors.initials: CR
authors.lastname: Victor
authors.forename: Anna
authors.initials: A
authors.lastname: Thomas
authors.forename: John
authors.initials: J
authors.lastname: Seargeant
mesh_terms: D000359:Aftercare / Q000458:organization & administration*; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D004739:England; D015577:Geriatric Assessment; D006302:Health Services Research; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D010348:Patient Care Team; D010351:Patient Discharge