Outcomes of 72-Hour Hospital Treatment Responsibility Post Discharge to Municipal Nursing Care.

BACKGROUND

The increasing prevalence of individuals living with chronic conditions and multi-morbidity presents challenges to healthcare systems and coordination of coherent patient pathways. In Denmark, transitions between healthcare sectors are susceptible to disruption due to inadequate cross-sectoral collaboration. To improve continuity of care and cross-sectoral collaboration, an agreement of 72-hour hospital treatment responsibility post-discharge was implemented.

METHODS

We used data from a questionnaire survey for healthcare professionals, data from electronic patient records, and data from cross-sectoral medical record audits to evaluate outcomes of the implementation of the agreement.

RESULTS

Survey data suggested that the agreement may enhance cross-sectoral collaboration by improving communication and understanding of other sectors, with municipal healthcare professionals perceiving these benefits more strongly. Data from electronic patient records indicated increased attention to discharge documentation. Medical record audits suggest that the agreement may be supportive where medication-related uncertainties necessitated clarification.

CONCLUSION

The evaluation shows that the agreement can facilitate cross-sectoral communication, in some cases may improve treatment quality and safety and may support safer transitions from hospital to municipal care. The agreement does not reduce readmissions among the target group in general; however, it might facilitate avoidance of unnecessary readmissions in cases where cross-sectoral dialogue is sufficient.