Health-related quality of life and patient experiences regarding care transitions in hospitalized older patients with chronic diseases

Abstract

Poorly executed care transitions from hospital to home can result in adverse outcomes, such as incorrect treatments, medication errors, patient dissatisfaction, rehospitalization, emergency department visits, and mortality. Integrated care services may improve the quality of these transitions, particularly for older, chronically ill patients who frequently move between care settings. This study aimed to (1) assess health-related quality of life (HRQoL) and older patients' experiences during transitional care i and (2) compare these outcomes between patients residing within and outside an integrated care region in Belgium. This cross-sectional survey study was part of the European TRANS-SENIOR project. Participants included patients aged 65 and older who were discharged home from one of six acute hospital wards at University Hospitals Leuven, Belgium. HRQoL was measured using the EQ-5D-5 L and a Visual Analogue Scale (0-100). Patient experiences were assessed using the 'Experiences with Hospital Care, Admission and Discharge' instrument. Descriptive statistics were applied to the full sample, and comparative analyses were conducted between patients living inside versus outside an integrated care region. Statistical significance was set at p < 0.05. A total of 119 questionnaires were completed. The mean age of participants was 81 years, and 54.2% were female. Over 70% reported issues with mobility, pain/discomfort, daily activities, and self-care. Patients reported high scores for the patient experience dimensions hospital accessibility, hospital safety and care received by physicians and nurses. However, lower scores were noted for treatment communication, admission conversations and hospital discharge processes. No statistically significant differences were found in HRQoL or most patient experience dimensions between those living within versus outside an integrated care region. This survey highlights areas for improvement in transitional care. This information can support hospitals and health care professionals in refining discharge, transfer and postdischarge processes for older patients with chronic conditions.

Keywords: Patient experience; Patient-reported outcomes; Survey; Transitional care.

Fig. 1

The EQ-5D-5 L health dimensions for the total sample.