Hospital discharge information and older patients: do they get what they need?

Background: Ineffective communication of hospital discharge instructions may have important implications for future health, function, and quality of life.

Objective: To describe patient recall of predischarge communication of discharge instructions by hospital staff, and to demonstrate the feasibility a posthospitalization survey in this urban, public hospital population.

Methods: Cross-sectional telephone survey of 269 patients age 70 years or older who were discharged from an academically affiliated urban public hospital between September 7, 2004, and January 19, 2005.

Results: The mean length of stay of the respondents was 5.6 days (range, 0-56 days), and the mean number of admissions over the study period was 1.6 (range, 1-7 times). The respondents were interviewed a average of 3 days after discharge (range, 1-10 days). Only 43.7% of the respondents replied yes when asked, "Did anyone talk with you about how to care for yourself at home after this hospitalization?" Among those who recalled how they received care instructions (n = 103), approximately 66.0% (n = 68) reported receiving instructions "verbally," 10.7% (n = 11) reported receiving written instructions, and 23.3% (n = 24) reported receiving both. More than half the respondents (54.2%) did not recall anyone talking with them about how to care for themselves after hospitalization. Other significant gaps in important patient information were identified.

Conclusions: We found that a posthospitalization survey was both feasible and revealing in this urban, public hospital population. Furthermore, interviewee recall of predischarge communication of discharge instructions by hospital staff demonstrated significant gaps in communication between these patients and the hospital care team at time of discharge.