Multimorbidity at Hospital Discharge Transition

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Introduction

The article under analysis is written by Doos et al. (2014) and entitled Heart Failure and Chronic Obstructive Pulmonary Disease Multimorbidity at Hospital Discharge Transition: A Study of Patient and Carer Experience. The article focuses on hospital discharge transition as seen by older patients. This study unveils the value the patients place on post-discharge contacts with healthcare professionals. This brief critique addresses the major aspects of the article in question.

Research Method, the Problem, and Purpose of the Research

Addressing the needs of patients with multimorbidity is one of the most significant challenges for care providers while admission and readmission rates of such patients are rather high. Therefore, the purpose of this study is to examine the views of COPD and heart failure patients and healthcare providers as well as the gaps in the healthcare system. Doos et al. (2014) use the mixed method design. They use quantitative analysis to explore some of the most common views on patients experiences after their discharge and use qualitative methods to gain more insights into the perspectives of patients on treatment outcomes, their overall satisfaction, and so forth.

Research Questions, Methods of Data Analysis Used

The authors do not set specific research questions, but it is possible to identify the major focus of their analysis. Doos et al. (2014) try to explore patients assessment of the care they received and identify the value of each area mentioned by the participants. The quantitative data were used to examine the participants overall views on their hospital experiences. Doos et al. (2014) employed American Hospital Consumer Assessment of Healthcare Providers and Systems questionnaire to identify some of the most common points the patients might display. This questionnaire covers such areas as communication with the providers of care, hospital stay satisfaction, data on any medical issues they encountered, their recommendations. The qualitative analysis phase involved the use of interviews with some of the participants. The interviews aimed at exploring the values the patients place on each item that could arise during the quantitative data collection stage.

Methods Appropriateness to the Design and Research Questions

Doos et al. (2014) use appropriate methods as they are instrumental in addressing the purpose of the study. The researchers try to explore patients satisfaction and their views on their hospital experiences. These perspectives can help in understanding some reasons for high readmission rates. The survey can also unveil some gaps in the healthcare system.

Results and Their Interpretation

The research involved 29 patients aged between 58 and 91 years old. The participants rated their health conditions as poor, but they were still discharged to home. Approximately 40% of the patients recommended the hospital rather than discharge. Over 70% of the participants were unaware of the reasons for the prescription of some medications, and over 60% had limited data on side-effects and other relevant aspects. The interviews provided valuable insights into the participants views on post-discharge care as they expressed their willingness to receive certain information during the first days after their discharge. Moreover, although the participants anticipated a healthcare professionals visit, no one came, which caused some confusion and dissatisfaction.

The information obtained is quite limited due to the small sample, but it is still sufficient to interpret the data and make conclusions. It is clear that patients need post-discharge communication with healthcare professionals. The study contributes to the existing knowledge base and unveils the existing gaps. The study on the effectiveness of additional data gathering after patients discharge is needed.

Reference

Doos, L., Bradley, E., Rushton, C., Satchithananda, D., Davies, S., & Kadam, U. (2014). Heart failure and chronic obstructive pulmonary disease multimorbidity at hospital discharge transition: A study of patient and carer experience. Health Expectations, 18(6), 2401-2412. 

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