Early discharge: What are the effects of programmes targeted at elderly orthopaedic patients?

Abstract

Early discharge from hospital is rapidly becoming acceptable hospital policy with increasing financial pressures that confront health services. Formalised programmes of early discharge have been developed in the United States, the United Kingdom and also Australia to support patients leaving hospital early, mainly in the areas of orthopaedics and maternity. The reviewed literature demonstrates an overall trend to deinstitutionalise health services and identifies the general effect of early discharge on the health service, carers and patients. Elderly patients following orthopaedic trauma are more likely to be dependent on others for their care than general patients. The aim of this study was to identify experiences and perceptions of elderly orthopaedic patients who participated in a programme of early discharge. The study involved semi-structured, in-depth interviews with a sample of six men and women who had been orthopaedic patients at the Hornsby Ku-ring-gai Hospital. Broad areas for discussion included expectations of the programme, experiences following discharge including any difficulties or problems encountered, use of formal services reported capacity to attend activities of daily living and the main areas of satisfaction and dissatisfaction. The findings revealed that patients preferred early discharge with support from both the rehabilitation discharge team and family to staying in hospital until fully recovered. Whilst experiences of this small sample cannot be generalised to the larger population, they provide insight to individual perceptions that can be used as the basis for further study.