title: Barriers to primary care hospital follow-up among older adults in rural or semi-rural communities.
abstract: BACKGROUND
  Failure to follow-up with a primary care provider (PCP) following discharge from an acute care setting is strongly associated with readmission within 90 days among elderly patients.
  
  
  OBJECTIVE
  The purpose of this study was to identify barriers to primary care follow-up among older adults in rural communities.
  
  
  METHODS
  This was an explanatory mixed methods study which included scaled survey and interview techniques. Descriptive and inferential statistics were calculated for scaled concepts. Standard content analysis was performed on the qualitative items.
  
  
  RESULTS
  Correlation between intention to follow-up with a PCP and actual follow-up was poor (r=0.20). Patients encountered substantial obstacles to the PCP follow-up visit. Obstacles clustered into two groups: 1) healthcare or social system barriers and 2) personal characteristics of patients.
  
  
  CONCLUSIONS
  Individualized discharge planning that reflects the complexities of post-hospitalization adaptation for elders is most likely to be useful for ensuring PCP follow-up.
authors: Clinical Nurse Leader, Texas Health Harris Methodist Hospital Azle, USA, 76020. Electronic address: robertahardman@texashealth.org.
authors: Bobbi
authors: B
authors: Hardman
authors: Nursing Research, Texas Health Resources, Fort Worth, USA, 76104. Electronic address: patricianewcomb@texashealth.org.
authors: Patricia
authors: P
authors: Newcomb
mesh_terms: D000359:Aftercare / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D019035:Rural Health Services / Q000600:supply & distribution*; D012424:Rural Population
keywords: Older adults; Primary care; Rural; Transitional care