Huby G O, van Teijlingen E R, Porter A M, Bury J
Department of General Practice, University of Edinburgh, Levinson House, 20 West Richmond Street, Edinburgh, EH8 9DX.
Health Bull (Edinb). 1997 Sep;55(5):338-50.
To document service use by people living with HIV/AIDS discharged from hospital, to identify gaps and overlaps in service provision after discharge, and to evaluate liaison between hospital-based and community-based services.
Four week follow-up diary and interview study of service users, and interview/questionnaire study of service providers.
Services used by people discharged from the wards of two units of two Lothian hospitals.
All patients with HIV infection admitted to the wards of two units of two Lothian hospitals from October 1992 to February 1993, and their service providers.
General practitioners were the most contacted service post discharge, but general practitioners did not appear to play a co-ordination role in service provision. Liaison on discharge was found to be effective in terms of continuity of care in most cases; and from a service user perspective, liaison between hospital and primary care agencies did not appear a major concern. The majority of hospital discharges were organised in a setting with a large number of services, with complex communication patterns and informal procedures of discharge arrangements. This created uncertainty among service providers as to the arrangements which had been made, and fear and anxiety that they fall through. On the other hand, the informality of discharge procedures also ensured flexibility and responsiveness to unexpected events and changes in service users' circumstances and was a vital factor in continuity of care experienced by them. A more important issue for service users was the poor integration of services concerned with social/material support in the system of medical and emotional care.
记录出院的艾滋病毒/艾滋病感染者的服务利用情况，确定出院后服务提供方面的差距和重叠之处，并评估医院服务与社区服务之间的联络情况。
对服务使用者进行为期四周的随访日记和访谈研究，以及对服务提供者进行访谈/问卷调查研究。
两家洛锡安医院两个科室病房出院患者所使用的服务。
1992年10月至1993年2月期间入住两家洛锡安医院两个科室病房的所有艾滋病毒感染患者及其服务提供者。
出院后联系最多的服务机构是全科医生，但全科医生在服务提供方面似乎并未发挥协调作用。在大多数情况下，出院时的联络在护理连续性方面是有效的；从服务使用者的角度来看，医院与初级保健机构之间的联络似乎不是主要问题。大多数患者出院时所在的环境中有大量服务机构，沟通模式复杂，出院安排程序不正规。这使得服务提供者对已做出的安排感到不确定，并担心这些安排无法落实。另一方面，出院程序的不正规也确保了灵活性以及对意外事件和服务使用者情况变化的响应能力，这是他们体验到护理连续性的一个关键因素。对服务使用者来说，一个更重要的问题是，社会/物质支持相关服务在医疗和情感护理体系中整合不佳。
