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Implementation of discharge plans for chronically ill elders discharged home
E K Proctor1, N Morrow-Howell, S J Kaplan
1Center for Mental Health Services Research, George Warren Brown School of Social Work, Washington University, St. Louis, MO 63130, USA.
Health & Social Work
|February 1, 1996
Summary
Many elderly patients with heart failure do not receive their planned hospital discharge care. Implementation problems lead to unmet needs and inadequate care, especially for low-income individuals.
Area of Science:
- Gerontology
- Health Services Research
- Cardiology
Background:
- Hospital discharge plans are crucial for post-discharge patient well-being.
- Limited understanding exists regarding the real-world implementation of these plans.
- Congestive heart failure (CHF) patients often require complex post-discharge support.
Purpose of the Study:
- To assess the implementation fidelity of discharge plans for elderly CHF patients.
- To examine the consequences of discharge plan implementation problems.
- To identify factors contributing to discharge plan implementation issues.
Main Methods:
- Retrospective chart review and patient follow-up.
- Analysis of discharge plan components and their execution.
- Statistical analysis to identify correlations between patient characteristics and implementation problems.
Main Results:
- Forty percent of elderly CHF patients experienced at least one discharge plan implementation failure.
- Implementation discrepancies were more prevalent in low-income patient populations.
- Negative outcomes included unmet patient needs and suboptimal care quality.
Conclusions:
- Discharge planning for elderly CHF patients faces significant implementation challenges.
- Socioeconomic status is a key factor influencing successful discharge plan execution.
- Addressing implementation gaps is vital for improving post-hospital care and patient outcomes.