About the project
This project is a national multi-centre study in collaboration with Gjøvik University College (HiG), Norwegian Social Research (NOVA) and SINTEF Health.
Background
In Norway there are structural and organisational differences between primary and secondary (e.g. hospital) health care provision. Yet, the two sectors interface continuously as individuals move in and out of each sector. Patients moving from hospitals to long-term primary health care are generally considered to be a major source of coordination problems.
Elderly patients are especially important in this respect. This group has a pattern of hospital service use that differs markedly from other age groups. Rates of admission have increased markedly the past ten years; length of stay has fallen comparatively; and the problem of rehospitalisation is increasing. Previous research suggests that improving inter-agency cooperation in health care yields major gains in terms of patient satisfaction, costs, medical outcomes and the frequency of rehospitalisation.
However, knowledge is sparse in terms of the characteristics of patient flow across the hospital and long-term sectors among persons 80 years and above.
The data gathering for the project was concluded in June 2009. The material consists of both quantitative and qualitative data. It includes personal interviews with 254 patients 80 years and older from 67 municipalities in Norway discharged from 14 hospitals. In addition 262 next of kin of the patients were interviewed via telephone. Altogether the existing empirical material consists of 516 interviews associated with 330 patient discharges from hospital.
Objectives
The main focus of the project is on the process of patients moving from hospitals to long-term primary health care. The aim of the project is to expand knowledge in three areas:
- Patient flow: the total patient flow from all types of hospitals into home care and nursing home care in the municipalities will be investigated.
- User perspectives: this covers participation, information and evaluation of the processes related to the transition process as experienced by patients 80+ and their primary caregivers.
- Inter-agency barriers: are there factors connected to care systems, professionals or patients that lead to major deficiencies for participants during the transition process?
The Group for Elderly Care Research (GEOF) is involved in all three phases, but has the major responsibility for Part two, user perspectives.
Publications
- Foss C, Askautrud M. Measuring the participation of elderly patients in the discharge process from hospital: A critical review of existing instruments. Scandinavian Journal of Caring Sciences 2010; 24; 46–55.
- Foss C, Hofoss D. Old persons experiences with participation during discharge process. Patient Education & Counseling 2011;85:68-73. Publication ahead of print
- Foss C. Elders and patient participation revisited – a discourse analytic approach to elderly persons’ reflections on patient participation. Journal of Clinical Nursing 2011; 20: 2014-22.
- Foss, Christina; Hofoss, Dag; Romøren, Tor Inge; Bragstad, Line Kildal & Kirkevold, Marit (2012). Eldres erfaringer med utskrivning fra sykehus . Sykepleien Forskning. ISSN 1890-2936. 7(4), s 324- 333 . doi: 10.4220/sykepleienf.2012.0154
- Bragstad, Line Kildal; Kirkevold, Marit; Hofoss, Dag; Foss, Christina. (2012) Factors predicting a successful post-discharge outcome for individuals aged 80 years and over. International Journal of Integrated Care 2012 ;Volum 12. 10 February 2012.
- Bragstad, Line Kildal; Kirkevold, Marit; Hofoss, Dag & Foss, Christina (2014). Informal caregivers' participation when older adults in Norway are discharged from the hospital . Health & Social Care in the Community; 22(2) 155-168. ISSN 0966-0410. . doi: 10.1111/hsc.12071
- Bragstad, Line Kildal: Kirkevold, Marit & Foss, Christina (2014). The indispensable intermediaries: a qualitative study of informal caregivers’ struggle to achieve influence at and after hospital discharge. BMC Health Services Research, Vol. 14:331 Doi: 10.1186/1472-6963-14-331
Sub-projects
Financing
- Norwegian Research Council (NFR)
Cooperation
- Gjøvik University College (HiG)
- Norwegian Social Research (NOVA)
- SINTEF Health
Start - Finish
2006-2011