Leave in Silence: Hospital Discharge Communication Problems in Older Adults in 11 Countries
Abstract
The transition from hospital care to another point of care is a critical moment in ensuring positive patient outcomes and safety. We aimed to determine the prevalence of hospital discharge communication problems in older adults in 11 high-income countries and the associated factors.
We analyzed data from the 2021 Commonwealth Fund International Health Policy (IHP) survey of older adults. Respondents were from 11 countries high-income countries. Poor discharge communication (PDC), a composite score, was defined as participants reporting at least 2 problems in the discharge process out of a maximum of 3. A multivariate logistic regression model assessed PDC’s association with potential risk factors.
Analyses were based on 4445 respondents hospitalized for at least one night in the last two years before the survey and answered discharge-related questions. The overall rate of PDC was 19.1% overall and was the highest in Norway (31.3%) and lowest in the US (7.5%). PDC was more likely to occur in those 75 years of age or greater and living in Canada, France, Germany, Netherlands, Norway, Sweden, Switzerland, and the United Kingdom. Of the three discharge communication problems identified, the most reported problem was medicines not being discussed at discharge, representing 27.4% of all individuals. Gender, education, income, and presence of at least one chronic disease were not associated with PDC.
In our analysis of hospital discharge communication problems in 11 high-income nations, almost 1 in 5 older adults experience PDC, although there is a wide variation between nations and those age 75 or older are at particular risk. Our results suggest that hospital discharge teams and leadership should carefully examine all communication during the hospital discharge process to ensure that care gaps are minimized.
Keywords
Hospital Discharge, Patient Communication, Older Adults, Commonwealth Fund, Survey Data, Secondary Analysis
Leave in Silence: Hospital Discharge Communication Problems in Older Adults in 11 Countries
The transition from hospital care to another point of care is a critical moment in ensuring positive patient outcomes and safety. We aimed to determine the prevalence of hospital discharge communication problems in older adults in 11 high-income countries and the associated factors.
We analyzed data from the 2021 Commonwealth Fund International Health Policy (IHP) survey of older adults. Respondents were from 11 countries high-income countries. Poor discharge communication (PDC), a composite score, was defined as participants reporting at least 2 problems in the discharge process out of a maximum of 3. A multivariate logistic regression model assessed PDC’s association with potential risk factors.
Analyses were based on 4445 respondents hospitalized for at least one night in the last two years before the survey and answered discharge-related questions. The overall rate of PDC was 19.1% overall and was the highest in Norway (31.3%) and lowest in the US (7.5%). PDC was more likely to occur in those 75 years of age or greater and living in Canada, France, Germany, Netherlands, Norway, Sweden, Switzerland, and the United Kingdom. Of the three discharge communication problems identified, the most reported problem was medicines not being discussed at discharge, representing 27.4% of all individuals. Gender, education, income, and presence of at least one chronic disease were not associated with PDC.
In our analysis of hospital discharge communication problems in 11 high-income nations, almost 1 in 5 older adults experience PDC, although there is a wide variation between nations and those age 75 or older are at particular risk. Our results suggest that hospital discharge teams and leadership should carefully examine all communication during the hospital discharge process to ensure that care gaps are minimized.
