Factors that predict discharge destination for patients in transitional care: a prospective observational cohort study
Natasha K. Brusco A B F , Nicholas F. Taylor A B , Ilana Hornung C , Shanandoah Schaffers D , Anna Smith E and Natalie A. de Morton AA La Trobe University, Bundoora, VIC 3186, Australia. Email: n.taylor@latrobe.edu.au, demortonn@ramsayhealth.com.au
B Eastern Health, 5 Arnold Street, Box Hill, VIC 3128, Australia.
C Western Health, 160 Gordon Street, Footscray, VIC 3011, Australia. Email: ilana.hornung@wh.org.au
D Peninsula Health, c/- Frankston Hospital, Hastings Road, Frankston, VIC 3199, Australia. Email: sschaffers@phcn.vic.gov.au
E Southern Health, 246 Clayton Road, Clayton, VIC 3168, Australia. Email: anna.smith@southernhealth.org.au
F Corresponding author. Email: nbrusco@cabrini.com.au
Submitted: 2 June 2011 Accepted: 5 March 2012 Published: 10 September 2012
Journal Compilation © AHHA 2012
Abstract
Objective. To investigate factors that predict discharge destination for patients making the transition from hospital to the community.
Methods. Using a prospective cohort design, 696 patients from 11 Transition Care Programs were recruited. Baseline patient and program characteristics were considered for predicting discharge destination, functional status, and patient length of stay.
Results. An increased physiotherapy staffing ratio in Transition Care Program was associated with an increased likelihood that a patient was discharged home, with an improved functional or mobility status, and after a shorter length of stay. The other factor that predicted discharge to home included having an Aged Care Assessment Service classification of low level care or home with a support package. An increased physiotherapy staffing level also reduced the likelihood of discharge to low level or high level care. The other factors that predicted discharge to low level care were having higher mobility status and older age; the other factor associated with increased likelihood of predicting discharge to high level care was having an Aged Care Assessment Service classification of high level care.
Conclusions. Factors on admission that predicted discharge destination were program physiotherapy staffing ratios, Aged Care Assessment Service assessment, age and mobility status.
What is known about the topic? In 2004/05 Australia introduced a program called the Transition Care Program (TCP), which targets older persons at the conclusion of an acute hospital episode who require more time and support in a non-acute setting to complete their restorative process and optimise their functional capacity. This program has a particular objective to prevent inappropriate admission to a residential aged care facility. To date, there are no published papers that report the factors that predict discharge destination for patients in the Transition Care Program.
What does this paper add? This study provides evidence that program physiotherapy staffing ratios, Aged Care Assessment Service assessment, age and mobility status are predictive of an increased likelihood that a patient will be discharged home with an improved functional/mobility status, after a shorter length of stay.
What are the implications for practitioners? Knowledge of factors that predict discharge destination may assist healthcare practitioners and health managers in managing TCP patients and planning services.
Additional keywords: aged care, function, mobility, physiotherapy, prediction factors, Transition Care Program.
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