Family Practice Advance Access published online on November 4, 2009
Family Practice, doi:10.1093/fampra/cmp076
Factors influencing general practice follow-up attendances of patients with complex medical problems after hospitalization
a General Practice Unit, Sydney South Western Area Health Service
b School of Public Health and Community Medicine, University of New South Wales
c Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales
d Department of Rehabilitation Medicine, Sydney South Western Area Health Service, Sydney, Australia
Correspondence to Shu Ching Yang, General Practice Unit, Sydney South Western Area Health Service, Sydney, Australia; E-mail: scytw77{at}gmail.com
Received 27 December 2008; Revised 13 September 2009; Accepted 29 September 2009.
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Abstract |
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Background. Supported discharge care of patients with complex medical problems is associated with improved health outcomes. GPs are ideally placed to provide post-discharge care in the community. Knowledge of factors that influence patients’ decisions to attend such follow-up is thus important to improve health care outcomes of these patients.
Objectives. To explore factors that influence complex medical patients’ decision to attend GP follow-up after discharge and factors affecting their level of satisfaction with such follow-up.
Methods. Qualitative investigation using semi-structured telephone interviews of 26 patients with complex medical issues conducted 2 weeks after hospital discharge.
Results. Complex medical patients experienced varying degrees of concern and information needs after discharge from hospital. Patients’ understanding of the role of the GP and experiences of continuity of care also influence patients’ decisions to attend follow-up with their GP. In addition, practical factors such as GP availability, presence of discharge instructions, access to transport and level of social support also affect patients’ ability to attend early GP follow-up after hospital discharge. Patients’ satisfaction with GP follow-up was influenced by perceived competence and personal continuity with the GP.
Conclusions. Patients’ decisions to attend GP follow-up after hospitalization are influenced by a number of factors. Interventions to support post-hospital care that address these issues need to be developed and tested. Key issues are patients’ understanding of their condition, understanding of the role of the GP in follow-up and continuity of care.
Keywords. Attitude to health, patient discharge, primary health care, qualitative study.
Yang SC, Zwar N, Vagholkar S, Dennis S and Redmond H. Factors influencing general practice follow-up attendances of patients with complex medical problems after hospitalization. Family Practice 2009; Pages 1–7 of 7.