Primary care based approaches to reduce readmissions: Older patients’ perspectives on the transition of care from secondary care to primary care

Conference:

SAPC ASM 2024 - Bristol

Talk Code:

6E.8

Presenter:

Geoff McCombe

Twitter:

@geoffmccombe

Co-authors:

Luke Sheeran-Purcell1, Geoff McCombe1, John Brougham1, Emils Sietins1, Ronan Fawsitt1,2, Martina Queally3, Timothy Lynch2, Walter Cullen1

Author institutions:

1School of Medicine, University College Dublin, Dublin, Ireland. 2 Ireland East Hospital Group, Dublin, Ireland. 3 Health Services Executive, Wicklow, Ireland.

Problem

Readmissions to hospital are expensive and can have negative health consequences for patients. Older adults are at greater risk of readmission. Patient perspectives are valuable in identifying areas for improvement in the transition of care. The aim of this qualitative study is to increase our understanding of patients’ perspectives on the transition of care from hospital to primary care.

Approach

This study used a qualitative methodology to conduct semi-structured interviews with patients who had been discharged from hospitals in the Ireland East Hospital Group (IEHG) region. Patients who had been discharged from hospital (n=82) were invited via ten general practices in the Ireland East region to participate in telephone interviews about their experience of care transition of care between primary and secondary care. Twenty-eight patients consented to participate in an interview. Interview transcripts were analysed using the ‘Braun and Clarke’ approach to thematic analysis.

Findings

Data saturation was reached after 18 interviews with no new themes emerging. Three main themes were identified: a) communication, b) outpatient supports and c) patient education. Participants reported both positive and negative experiences of communication between the hospital and their GP and the hospital and pharmacies in relation to post-discharge prescriptions. Participants reported benefiting from a wide variety of outpatient supports including general practice, family, carers, allied health professionals and voluntary organisations. Access and cost were barriers to these supports. Participants were generally positive towards proposed primary care-based interventions such as follow up appointments with general practitioners and education sessions.

Consequences

This study highlights a number of areas for improvement in transition of care for current practice including communication between services and access to outpatient care and suggests directions for further research, such as explorations of healthcare provider perspectives and interventions to reduce hospital readmissions.

Submitted by:

Geoff McCombe

Funding acknowledgement:

We are grateful to Ireland East Hospital Group, the UCD School of Medicine, and the UCD College of Health and Agricultural Sciences for supporting this project.