From hospital to post-acute care organizations: the relationship between patient experience and health recovery.

OBJECTIVE: To determine to what extent patient health status and recovery in post-acute care organizations (PACO) is related to patient experience of the discharge process from hospital and to patient experience while staying in these facilities. DESIGN: Longitudinal study of patients discharged from hospitals to PACO. SETTING: 12 hospitals and 14 PACO Portuguese organizations. PARTICIPANTS: 181 patients participated in the both stages of data gathering. MAIN OUTCOME MEASURES: Patients' physical and mental health status was measured through the 36-item short form health survey scale. The experience of transition from hospital to PACO was measured with the Care Transition Measure. The Picker Adult In-Patient Questionnaire was used to measure patients' experience in these organizations. RESULTS: Patients reporting better physical condition in PACO had a better experience on discharge [b = 0.21, 95% confidence interval, CI (0.10, 0.31)] and perceive fewer problems inside facilities [b = - 0.19, 95% CI (-0.31, 0.08)]. The experience in PACO is significantly related to patients' mental health status [b = - 0.47, 95% CI (-0.59, - 0.36)]. Patients showing higher levels of physical recovery had a better experience on discharge [b = - 0.18, 95% CI (0.08, 0.28)], while those registering better mental recovery experienced fewer problems during their stay [b = - 0.41, 95% CI (-0.52, - 0.30)]. CONCLUSIONS: PACO play a key role in maintaining and promoting patients' health, and this goal is influenced by their experience both in the transition from hospitals to PACO and while staying in these facilities.

Implementation and impact of integrated health and social care services: an umbrella review.

Governments in many European countries have been working towards integrating health and social care services to eliminate the fragmentation that leads to poor care coordination for patients. We conducted a systematic review to identify and synthesize knowledge about the integration of health and social care services in Europe. We identified 490 records, in 14 systematic reviews that reported on 1148 primary studies and assessed outcomes of integration of health care and social care. We categorized records according to three purposes: health outcomes, service quality and integration procedures outcomes. Health outcomes include improved clinical outcomes, enhanced quality of life, and positive effects on quality of care. Service quality improvements encompass better access to services, reduced waiting times, and increased patient satisfaction. Integration procedure outcomes involve cost reduction, enhanced collaboration, and improved staff perceptions; however, some findings rely on limited evidence. This umbrella review provides a quality-appraised overview of existing systematic reviews.