노인의 퇴원 후 전환기 돌봄서비스 필요도에 대한 예측요인

Abstract

Chronic diseases in the growing elderly population lead to repeated hospitalizations and consequent deterioration of older adults' health, highlighting the importance of appropriate post-discharge patient care services during the care transition period from the hospital to their homes or a nursing facility. This study aimed to investigate older adults’ need for transitional care services (TCS) and identify the associated factors. A 1:1 phone survey was conducted on 300 older adults aged ≥65 years who resided in Gangwon Province, Republic of Korea. To identify predictors of older adults’ need for TCS, personal factors (sex, age, education level, residence, economic status), disease-related factors (self-rated health status, noncommunicable diseases and chronic conditions, hospitalization within the last 2 years), and care-related factors (spending time alone during daytime, need assessment of activities of daily living (ADLs), cohabitations) were examined, and the data were analyzed using descriptive statistics and multiple regression analysis. The results indicated that older adults exhibited a high need for TCS, with the greatest need being “information and training on self-management of health after discharge,” “information on social welfare (life support) services available near the patient’s living area,” and “description of the diagnosis, current condition, treatment plan, and outcome at the time of admission.” Additionally, the most common post-discharge difficulties experienced by older adults who had been hospitalized over the last 2 years were “physical discomfort” (3.7) and “psychological discomfort” (3.0). Hierarchical regression analysis revealed that noncommunicable diseases and chronic conditions (among disease-related factors) and need assessment of ADLs (among care-related factors) were identified as predictors of the need for TCS (β=0.206, p<0.001 and β=-0.171, p<0.01, respectively). Based on these results, we proposed the necessity to provide post-discharge TCS for elderly patients, especially older adults with multiple chronic diseases or those with poor ADLs, who should be prioritized for these services.

Development of Items for Transitional Care Service and Outcome Indicators of Discharged Patients for Improvement in Quality of Care

“…The results of this study were consistent with those of previous studies. Dronina et al 28 investigated the need for TCS in older adults and reported that the need for “information on social welfare services/resources available in an area in proximity to the patient’s place of living” was high. As a result of examining the need for financial assistance for older women with liver cancer, 29 patients exhibited a high need (72.2%) for support of connection to community resources through the in-hospital social services team.…”

Effects of Transitional Care after Hospital Discharge in Patients with Chronic Obstructive Pulmonary Disease: An Updated Systematic Review and Meta-Analysis

“…According to a study that identified the difficulties experienced by patients in the process of moving to long-term care institutions or elderly living facilities after being discharged from the hospital, the unmet needs of elderly patients, especially at the time of discharge, are related to the diagnosis and treatment plan. Training and information for self-management after discharge and information on social welfare services available near the residence were provided [13][14][15].…”