Surgical patient values frame and modify the impact of risk factors for non-routine postdischarge care: A mixed-methods study
| Autor: | Xavier Baldwin, Paul Mihas, Ursula Adams, Stephanie T Lumpkin, Timothy S. Carey, Karyn B. Stitzenberg |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Psychological intervention Aftercare Patient Readmission Colonic Diseases 03 medical and health sciences 0302 clinical medicine Risk Factors medicine Humans Prospective Studies 030212 general & internal medicine Aged High rate Surgical team business.industry General Medicine Emergency department Middle Aged Patient Acceptance of Health Care Colorectal surgery Rectal Diseases Healthcare utilization 030220 oncology & carcinogenesis Emergency medicine Female Surgery Self Report Patient report Emergency Service Hospital business Attitude to Health Algorithms Surgical patients |
| Zdroj: | The American Journal of Surgery. 221:195-203 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/j.amjsurg.2020.05.016 |
| Popis: | Background Adult colorectal surgery patients continue to have high rates of readmissions, despite known risk factors for non-routine postdischarge care (emergency department (ED) visit or rehospitalization) and countless interventions to address these. It is unclear how the difficult-to-quantify patient perspective frames and modifies the impact of these quantifiable risk factors. Study design We identified consecutive adult inpatient colorectal surgery patients from 2017 to 2018. This mixed methods study merged data from electronic health records and in-depth patient interviews. Results We enrolled 258 participants, surveyed 167, and interviewed 18. Depressive symptoms represent one of many risk factors confirmed to increase non-routine healthcare utilization (RR 1.85, 95% CI 1.02–3.37), though the patient perspective explained why these symptoms seemed to greatly impact some patients more than others. Additionally, consistent with patient report, patients with non-routine postdischarge care (26%) were less likely to report communication with their surgical team (80% vs 97%, p Conclusion Patient perspectives add depth and understanding of the impact of risk factors on non-routine post-discharge care. This expanded knowledge explains why one patient is more likely to visit an ED close to home whereas another patient might prefer to visit their surgeon’s clinic directly. Effective strategies to reduce unplanned postdischarge care should be tailored. |
| Databáze: | OpenAIRE |
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