Factors influencing general practice follow-up attendances of patients with complex medical problems after hospitalization.
BACKGROUND
Supported discharge care of patients with complex medical problems is associated with improved health outcomes. GPs are ideally placed to provide post-discharge care in the community. Knowledge of factors that influence patients' decisions to attend such follow-up is thus important to improve health care outcomes of these patients.


OBJECTIVE
To explore factors that influence complex medical patients' decision to attend GP follow-up after discharge and factors affecting their level of satisfaction with such follow-up.


METHODS
Qualitative investigation using semi-structured telephone interviews of 26 patients with complex medical issues conducted 2 weeks after hospital discharge.


RESULTS
Complex medical patients experienced varying degrees of concern and information needs after discharge from hospital. Patients' understanding of the role of the GP and experiences of continuity of care also influence patients' decisions to attend follow-up with their GP. In addition, practical factors such as GP availability, presence of discharge instructions, access to transport and level of social support also affect patients' ability to attend early GP follow-up after hospital discharge. Patients' satisfaction with GP follow-up was influenced by perceived competence and personal continuity with the GP.


CONCLUSIONS
Patients' decisions to attend GP follow-up after hospitalization are influenced by a number of factors. Interventions to support post-hospital care that address these issues need to be developed and tested. Key issues are patients' understanding of their condition, understanding of the role of the GP in follow-up and continuity of care.
Yang
Shu Ching
SC
General Practice Unit, Sydney South Western Area Health Service, Sydney, Australia. scytw77@gmail.com
Zwar
Nicholas
N
Vagholkar
Sanjyot
S
Dennis
Sarah
S
Redmond
Helen
H
D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003266:Continuity of Patient Care; D003657:Decision Making; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010351:Patient Discharge; D017060:Patient Satisfaction