title: Hospital discharge of elderly patients to primary health care, with and without an intermediate care hospital - a qualitative study of health professionals' experiences.
abstract: BACKGROUND
  Intermediate care is an organisational approach to improve the coordination of health care services between health care levels. In Central Norway an intermediate care hospital was established in a municipality to improve discharge from a general hospital to primary health care. The aim of this study was to investigate how health professionals experienced hospital discharge of elderly patients to primary health care with and without an intermediate care hospital.
  
  
  METHODS
  A qualitative study with data collected through semi-structured focus groups and individual interviews.
  
  
  RESULTS
  Discharge via the intermediate care hospital was contrasted favourably compared to discharge directly from hospital to primary health care. Although increased capacity to receive patients from hospital and prepare them for discharge to primary health care was viewed as a benefit, professionals still requested better communication with the preceding care level concerning further treatment and care for the elderly patients.
  
  
  CONCLUSIONS
  The intermediate care hospital reduced the coordination challenges during discharge of elderly patients from hospital to primary health care. Nevertheless, the intermediate care was experienced more like an extension of hospital than an included part of primary health care and did not meet the need for communication across care levels.
authors.affiliation: Department of Public Health and General Practice, Norwegian University of Science and Technology, 7491 Trondheim, Norway.
authors.forename: Unni
authors.initials: U
authors.lastname: Dahl
authors.affiliation: Department of Public Health and General Practice, Norwegian University of Science and Technology, 7491 Trondheim, Norway.
authors.forename: Aslak
authors.initials: A
authors.lastname: Steinsbekk
authors.affiliation: Central Norway Health Authority, 7500 Stjørdal, Norway.
authors.forename: Svanhild
authors.initials: S
authors.lastname: Jenssen
authors.affiliation: Department of Public Health and General Practice, Norwegian University of Science and Technology, 7491 Trondheim, Norway.
authors.forename: Roar
authors.initials: R
authors.lastname: Johnsen
keywords: coordination; elderly; hospital discharge; integrated care; intermediate care hospital; professional communication