A plan for post-discharge patient care formulated by the section in charge of post-discharge coordination a T nuclear hospitals in a secondary medical care zone; and an analysis of the capability of full-time nurses in coordinating it

2005 Fiscal Year Final Research Report Summary

• Project/Area Number: 15592353
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Community health/Gerontological nurisng
• Research Institution: Gunma Prefectual College of Health Sciences (2005); Gunma Prefectual College of Health Science (2003-2004)
• Principal Investigator: IIDA Mitsue Gunma Prefectual College of Health Sciences, School of Nursing, Lecturer, 看護学部, 講師 (80272269)
• Co-Investigator(Kenkyū-buntansha): USHIGOME Miwako Gunma University, Department Medicine, Professor, 医学部, 教授 (10176654) ; SHIMIZU Chiyoko Gunma Prefectual College of Health Sciences, School of Nursing, Associate Professor, 看護学部, 助教授 (90258880) ; FUKUSHIMA Masako Gunma Prefectual College of Health Sciences, School of Nursing, Assistant, 看護学部, 助手 (20352619) ; SASAKI Kyoko Gunma University, Department Medicine, Instructor, 医学部, 助手 (20334104)
• Project Period (FY): 2003 – 2005
• Keywords: discharge coodination / discharge planning / nurses discharge coordinator / days for discharge coodination / hospitalization days / place of dischage / secondary medical service region / regional liaison

Research Abstract

1.Outline of the study
The current study, which focuses on nuclear hospitals in a secondary medical care zone, is intended to examine a model for correlation between the community and the characteristics of the patients who utilize post-discharge services offered by nurses in charge of such coordination.
1) Search of factors affecting the number of days required to coordinate the post-discharge process for 252 patients who were discharged, using the discharge coordination service in 2002 : the duration when discharge was pending, the number of days for coord inating discharge and the length of stay at the hospital were examined by using correlation coefficients. The facilities to which the patients were discharged to were classified by their organizational functions and a multiple regression analysis was conducted, using the number of days required for coordinating discharge as an induced variable and patient attributes and the facilities to which they were discharged as independent vari ables.
1)The after-discharge addresses of the 883 patients who utilized the 2001-2003 discharge coordination service and the organization of the medical service zones classified by their functions : The facilities to which the patients were discharged were classified by the ir functions: the patients' addresses and the locations of the facilities to which they were discharged were sorted by secondary medical care zone, city, town or village to find the organization of the zone formed by those who are cared for at home and to compute the percentage of locations of the facilities used by post-discharge patients within these residential zones.
2.Outline of the results
1)A strong correlation between the length of stay at a hospital and the time needed to make a request for coordination of one's discharge and the number of days needed to coordinate one' s discharge was noted (r=0.843 and r=0.639, respectively ; both with p<0.01). There was no significant correlation between the time needed to make a request for coordination for one' s discharge and the number of days needed to coordinate one' s discharge (r=0.124). It was confirmed that the latter varies significantly, depending on medical care management and disease and facility classification. In the multiple regression analysis using these three factors as independent variables, the contribution rate of 0.224 was explained by the following: "hospitals having a general ward or a general ward as well as a convalescent ward," "hospitals with a convalescent ward and one for nursing care," "medical care management," "hospitals with a psychiatric ward, convalescent ward and nursing facility," and "hospitals with a general ward, convalescent ward and nursing care."
2)The patients' addresses were scattered over 4 secondary medical care zones located in 11 cities, towns or villages. The facilities to which these patients were discharged numbered 39 in 4 secondary medical service zones. Overall, 75.1% of the patients were discharged to 7 "hospitals having a general ward, a convalescent ward and a ward where nursing care was offered." When limited to the zone of the survey area, 77.9% were discharged to 2 facilities of an identical type. Those discharged within the zone of their residence was 83.9%.