Hospital physicians’ views on discharge and readmission processes: a qualitative study from Norway

Abstract

ObjectivesTo explore hospital physicians’ views on readmission and discharge processes in the interface between hospitals and municipalities.DesignQualitative case study.SettingThe Norwegian healthcare system.ParticipantsFifteen hospital physicians (residents and consultants) from one hospital, involved in the treatment and discharge of patients.ResultsThe results of this study showed that patients were being discharged earlier, with more complex medical conditions, than they had been previously, and that discharges sometimes were perceived as premature. Insufficient capacity at the hospital resulted in pressure to discharge patients, but the primary healthcare service of the area was not always able to assume care of these patients. Communication between levels of the healthcare service was limited. The hospital stay summary was the most important, and sometimes only, form of communication between levels. The discharge process was described as complicated and was affected by healthcare personnel, by patients themselves and by aspects of the primary healthcare service. Early hospital discharges, poor communication between healthcare services and inadequacies in the discharge process were perceived to affect hospital readmissions.ConclusionThe results of this study provide a better understanding of hospital physicians’ views on the discharge and hospital readmission processes in the interface between the hospital and the primary healthcare service. The study also identifies discrepancies in governmental requirements, reform regulations and current practices in municipalities and hospitals.

Life satisfaction in Norwegian medical doctors: a 15-year longitudinal study of work-related predictors

“…These doctors experienced the health service reforms mentioned in the introduction in the most stressful years of their early career. There is evidence that the Hospital Reform in 2002 and the Coordination Reform in 2012 have increased pressures on both hospital physicians and general practitioners in Norway [55, 56].…”

Nurses' assessments of staffing adequacy in care services for older patients following hospital discharge

“…The coordination between hospital and community care nurses in the discharge of older patients have the characteristics of a collaborative chain, that is ‘relatively independent work performed in a sequential flow of tasks where the actors involved relate to each other asymmetrically’ (p.2, Paulsen et al., 2013). Problems in vertical coordination arise because the two settings (hospital and community care services) are both under pressure, with separate financial and organizational structures and are pursuing different professional goals (Knutsen Glette et al., 2019). Neither setting is fully aware of the needs, limitations and pressures of the other (Payne et al., 2002; Petersen et al., 2019).…”

Duration of sick leave after same-day discharge for lower extremity arterial disease and varicose vein interventions in active population of French patients, 2013–2016: observational study

“…As a consequence, outpatient endovascular procedures for patients with LEAD may result in shifting the burden of early postprocedural follow-up to ambulatory health services and in increasing the time before resuming work. 4 To approximate the burden of postprocedural rehabilitation in the context of inpatient and outpatient settings, we propose to compare the number of days of medical leave from work and the number of their renewals after intervention. Research conducted on sick leave according to intervention settings for the treatment of varicose vein and angioplasty with stent placement for LEAD is scarce.…”