Health-related quality of life and patient experiences regarding care transitions in hospitalized older patients with chronic diseases: a cross-sectional survey study

Abstract

Background Poorly performed care transitions from the hospital back home can lead to negative consequences, such as replication of services, missed diagnosis or incorrect treatment, medication errors, dissatisfaction among patients, rehospitalization, emergency department visits, or mortality. Implementing integrated care services can improve the quality of care transitions for older chronically ill patients who experience frequent transitions between care settings. The aim of this study was 1) to assess health-related quality of life (HRQOL) and person-centred care experiences with transitional care in older patients and 2) to compare these outcomes between patients who were living within or outside an integrated care region in Belgium. Methods This cross-sectional survey study was part of the European TRANS-SENIOR project. We included patients aged 65 years and older who were discharged home from one of six different acute hospital wards of the University Hospitals Leuven in Belgium. We measured HRQOL using the EQ-5D-5L and a Visual Analogue Scale ranging from 0 to 100, and patient experiences using the ‘Experiences with Hospital Care, Admission and Discharge’ instrument. Descriptive statistics were applied on the total sample. Comparative analyses were done for patients living inside or outside an integrated care region. Level of statistical significance was set at p < 0.05. Results A total of 119 questionnaires were completed. The patients had a mean age of 81 years, and 54.2% were female. Over 70% of the participants reported having problems with mobility, pain/discomfort, daily activities and self-care. Patients reported high scores for the patient experience dimensions hospital accessibility, hospital safety and care received by doctors and nurses. However, lower patient experience scores were observed for treatment communication, admission conversation and hospital discharge. There were no statistically significant differences in terms of HRQOL or most patient experience dimensions between patients living within or outside an integrated care region. Conclusion Our survey identified potential areas for improving patient-centred care experiences with transitional care. This information can support hospitals and health care professionals in changing the discharge, transferring and postdischarge processes for older patients with chronic diseases.