Use of nursing and social services by elderly patients discharged from hospital

As part of a study to determine reasons for early unplanned readmission of elderly patients to hospital, the provision of nursing and social services before and after admission was assessed for two groups of patients aged 65 years and over. A random sample of 133 patients who had been readmitted in an emergency and 133 matched controls who had not been readmitted were interviewed. Prior to the first admission the readmitted patients had received more services than the control patients. A substantial number of patients had had some services organized for them before leaving hospital. There was a net increase in the provision of district nursing services for both groups. The readmitted group had significantly more nursing and social services both before and after discharge than the non-readmitted group. The level of district nursing, home help and social work all increased significantly with age. Problems were experienced with services after discharge from hospital. These included: no arrangements, delay in starting services and inadequate services to meet the patient's needs. Guidelines for the provision of nursing and social services after discharge of patients from hospital are suggested.