Compliance of Frail Elderly With Health Services Prescribed at Discharge From an Acute-Care Geriatric Ward

Bibliographic Data

ID9099399
AuthorsNicole Leduc (Université de Montréal, corresponding author), Terry Tannenbaum (corresponding author), Terry Nan Tannenbaum, Howard Bergman (0000-0002-7410-1707, Jewish General Hospital), François Champagne (corresponding author), A Mark Clarfield (0000-0002-0388-5663, McGill University), Sandra Kogan (Jewish General Hospital)
Year1998
Volume36
Issue6
Pages904-914
Publication date1998-06-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-199806000-00013
PMID9630131
OpenAlexW2078938494
LanguageEN
Citations received1
References cited24

OBJECTIVES: A model of compliance by frail elderly with prescribed healthcare services was developed and tested. The discrepancy between primary care, geriatric and community health center (CLSC) services prescribed at discharge after comprehensive geriatric evaluation and treatment was measured, as were those services actually used during a 6-week interval (compliance). In this model, compliance was directly related to elders' intention to adhere to prescribed services, but this relationship was modified by organizational factors, reinforcing factors, and changes in health status during the observation period. Intention to adhere resulted from individual and reinforcing factors existing before discharge. METHODS: This model was tested on 211 patients discharged to community settings from an acute-care hospital geriatrics ward. Information was obtained through interviews with the patients or care givers and from hospital, outpatient, and local community health center charts. RESULTS: On average, patients used 56.9% of services prescribed; 13% of patients did not use any of the services prescribed for them, whereas 22% used all the services prescribed. Intention to adhere was influenced by patients' perception of the benefits of prescribed services and by their perception of the ease of access to transportation. Intention itself was not found to be an important determinant of overall compliance. Among organizational factors, having the ward staff make a follow-up appointment with the patients' family doctor and with the geriatric clinic before discharge and communication with the local community health center increased overall compliance. Moreover, patients who perceived they had access to transportation and to an accompanying person were more likely to comply. CONCLUSIONS: The results suggest that when discharging patients to the community, steps taken for them by the discharging healthcare providers will improve compliance

Acute care · Compliance (psychology) · Family medicine · Geriatrics · Health care · Medical emergency · Psychiatry · Frailty in Older Adults · Geriatric Care and Nursing Homes · Medication Adherence and Compliance · Medicine · Nursing · Psychology · Gerontology