Dissertation/Thesis Abstract

The Relationship between Discharge Planning, Satisfaction, and Readmission in Home Care Patients
by Hohl, Dawn A., Ph.D., Northcentral University, 2012, 179; 3531497
Abstract (Summary)

Many factors influence, and research supports a linkage, between a patient's perception of the hospital experience, the subsequent transition home, and hospital readmission. The problem is that when the patient perceives discharge planning to be inadequate, dissatisfaction and rehospitalization occurs. Unfortunately, predictors that create a satisfying patient transition from the hospital to home with home care are neither well studied nor well understood. This quantitative, nonexperimental, correlational design using survey methodology examined whether the type of hospital and discharge planning predict home care satisfaction, and whether home care satisfaction, and home care coordinator attendance of Interdisciplinary Team (IDT) rounds predicts subsequent hospital readmission. The Expectancy Disconfirmation Theory (EDT) serves as the framework for analysis. Fifty-five adult patients who were discharged from a major health system and referred to and accepted by the system's home health agency participated in the study. The survey combined existing valid instruments that rate the care transition, readiness for hospital discharge, and satisfaction with home care services. Data were analyzed using multiple regression, discriminant analysis, and a chi-square test. Hospital type (p < .05), care transitions (R2 = .32, F(2, 52) = 10.92, p < .01), and readiness for discharge (R 2 = .19, F(2, 52) = 6.19, p < .002) were found to significantly predict patient satisfaction with home care after patients are discharged from a hospital. Hospital type and patient satisfaction with arranging home care services significantly predict hospital readmission (R2 = .37, λ, = .86, χ2 (2) = 7.15, p = .03); whereas satisfaction with home care services management or personal issues with home care satisfaction and home care coordination attendance of IDT rounds did not predict readmission within 30 days. Future research in examining these linkages and other important predictors is warranted. Emerging regulations and the advent of value-based purchasing are pushing the continuum of care to work together. The findings of the study suggest that transitions are an area worthy of focus to identify predictors and align team models to impact satisfaction and readmission outcomes.

Indexing (document details)
Advisor: Gossett, Kenneth
School: Northcentral University
School Location: United States -- Arizona
Source: DAI-B 74/02(E), Dissertation Abstracts International
Subjects: Health care management
Keywords: Discharge planning, Home health care, Hospital readmissions, Patient satisfaction
Publication Number: 3531497
ISBN: 978-1-267-73438-9
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