If you build it, will they come? A mixed-method formative evaluation of the start-up of a post-discharge clinic to improve care transitions

Résumé fourni par la source

Abstract Background The transition from hospital care to post-discharge follow-up is pivotal for patient health and healthcare system efficiency. While Post Discharge Clinics (PDCs) are designed to facilitate this transition, these new ventures can face challenges, such as patient adherence to appointments. Formative evaluations can provide guidelines for their effective implementation. Methods A mixed-method formative evaluation was conducted at the University of Alabama at Birmingham Health System (UABHS)‘s PDC to evaluate the first 12 months of operation. The study combined quantitative analysis of patient characteristics, appointment status, and comorbidities with qualitative interviews of PDC staff to assess operational performance and identify areas for improvement. Results The quantitative analysis reported results on 2,168 PDC appointments during the study period. About half of the referred patients attended their appointment (52.1%), while the rest either cancelled (24.0%) or did not show up (23.3%). Statistically significant associations were found between patient demographic, socioeconomic, and clinical factors (e.g., marital status, insurance type, comorbidities) and adherence to appointments. The qualitative findings with PDC staff highlighted perceived benefits of the clinic, challenges in patient engagement, and the need for dedicated resources, such as social workers and specialists to optimize potential benefits. Conclusions The initial operation of the UAB PDC indicates the potential effectiveness of such clinics in improving transitional care. However, addressing barriers to patient adherence, particularly for socially vulnerable groups, and enhancing resource allocation based on stakeholder engagement are critical for the success and scalability of PDCs.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.