Ambade Preshit Nemdas, Hoffman Zach, Vest Tyler, Mehra Kaamya, Gunja Munira, MacKinnon Breagh H, MacKinnon Neil J
College of Medicine, Central Michigan University, Mount Pleasant, Michigan, USA
School of Public Health, Augusta University, Augusta, Georgia, USA.
BMJ Open. 2025 Jan 4;15(1):e089430. doi: 10.1136/bmjopen-2024-089430.
To determine the prevalence of hospital discharge communication problems with older adults, compare them across countries and determine factors associated with those problems.
Secondary analysis of cross-sectional survey data.
2021 Commonwealth Fund International Health Policy (IHP) Survey of Older Adults conducted across 11 high-income countries, including Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the UK and the USA.
4501 respondents aged 60 and older in the USA and 65 and older in all other included countries who were hospitalised at least once in the past 2 years before the survey and answered discharge communication-related questions.
Our primary outcome measure is poor discharge communication (PDC), a composite variable of three IHP questions related to written information, doctor follow-up and medicines discussed.
Overall PDC rate was 19.2% (864/4501), although rates varied by nation. PDC was highest in Norway (31.5%) and lowest in the USA (7.5%). Gender, education, income and the presence of at least one chronic disease were not statistically associated with PDC.
Given the high rate of PDC observed, hospital discharge teams and leadership should carefully examine communication during the hospital discharge process to ensure minimisation of care gaps, particularly regarding medication, since this was the most reported problem.
确定与老年人出院沟通问题的发生率，比较各国之间的情况，并确定与这些问题相关的因素。
横断面调查数据的二次分析。
2021年英联邦基金国际卫生政策（IHP）对老年人的调查，该调查在11个高收入国家进行，包括澳大利亚、加拿大、法国、德国、荷兰、新西兰、挪威、瑞典、瑞士、英国和美国。
美国4501名60岁及以上的受访者，以及所有其他纳入国家65岁及以上的受访者，他们在调查前的过去2年中至少住院一次，并回答了与出院沟通相关的问题。
我们的主要结局指标是出院沟通不良（PDC），这是一个由IHP三个与书面信息、医生随访和药物讨论相关问题组成的复合变量。
总体PDC率为19.2%（864/4501），尽管各国的比率有所不同。挪威的PDC率最高（31.5%），美国最低（7.5%）。性别、教育程度、收入和至少患有一种慢性病与PDC无统计学关联。
鉴于观察到的PDC率较高，医院出院团队和领导层应仔细检查出院过程中的沟通情况，以确保将护理差距降至最低，尤其是在药物方面，因为这是报告最多的问题。
