The importance of older patients’ experiences with care delivery for their quality of life after hospitalization (original) (raw)

2015, BMC Health Services Research

Background: Older patients' experiences with care delivery may be important for their quality of life over time. Evidence is however lacking. Therefore, this study aims to identify the longitudinal relationship between older patients' experiences with hospital care, perceived quality of integrated care and quality of life after hospitalization. Methods: Our longitudinal research was based on a pilot study of older people who had recently been admitted to a hospital. In the pilot study, all patients (≥65 years of age) who were admitted to the Vlietland hospital between June and October 2010 were asked to participate, which led to the inclusion of 500 older patients at baseline. A total of 291 patients (58 % response rate) were interviewed 3 months after admission. Measures included quality of life, patients' perceptions of quality of integrated care delivery and patients' experiences with hospital care. We used descriptive statistics, correlations, and multilevel analyses. Results: Being married (p ≤ 0.05), patients' experiences with hospital care, perceived quality of integrated care delivery (both p ≤ 0.01), and quality of life within 48 h of hospital admission (p ≤ 0.001) significantly correlated with quality of life 3 months after hospital admission. After controlling for background characteristics, multilevel analysis indicated a longitudinal relationship between patients' experiences with hospital care (p ≤ 0.05), perceived quality of integrated care delivery (p ≤ 0.01) and patients' quality of life 3 months after hospitalization. Conclusions: This study found a longitudinal relationship between patients' perceived quality of integrated care delivery, experiences with hospital care and quality of life of older patients after hospitalization. These results underscore the importance of enhancing older patients' experiences with care delivery. Background With the aging population healthcare professionals are increasingly dealing with older patients suffering from multiple chronic diseases. This poses challenges for the complex coordination of tasks performed during care delivery [1]. Their intense use of health services puts older patients at greater risk of receiving fragmented or poor-quality care [2, 3]. Once admitted to the hospital, older patients are at an increased risk for poor outcomes such as readmission, increased length of stay, functional decline, iatrogenic complications, and nursing home placement [4]. Schwarz [5] found a 33 % rate of readmission within 3 months for older patients, which