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      Interorganizational Collaboration in Transitional Care – A Study of a Post-Discharge Programme for Elderly Patients

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          Abstract

          Introduction and aim:

          This article reports a study of a post-discharge programme for elderly patients in Norway. It took place in an intermediate ward for transitional care and was based on collaboration between a municipality and a hospital, which was part of a health enterprise. The aim of the study was to analyse the collaboration and its possible effects on the quality of patient care, and the economic efficiency of the project for the organizations involved.

          Methodology:

          A mixed-methods approach, consisting of interviews, questionnaires and analyses of official documents and statistics.

          Results:

          The collaboration was working well on the top level of the organizations, but was more problematic on the operative level. However, there were clear signs of improvement. The patients who received transitional care were more satisfied with their stay at the ward than their previous stay at the hospital. They were discharged to their homes more often and perceived to have a higher level of functioning than the hospital patients. Average costs per patient were also lower in the ward than in the hospital departments.

          Conclusion:

          The collaboration had mainly positive impacts on the quality of patient care and the economic efficiency of elderly care in the municipality. However, the board of the health enterprise decided to close down the intermediate ward.

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          Most cited references38

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          Improving the quality of transitional care for persons with complex care needs.

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            Patient satisfaction: a review of issues and concepts.

            This review presents issues arising from an analysis of over 100 papers published in the field of patient satisfaction. The published output appearing in the medical and nursing literature which incorporated the term "patient satisfaction" rose to a peak of over 1000 papers annually in 1994, reflecting changes in service management especially in the U.K. and U.S.A. over the past decade. An introductory section discusses the setting and measurement of patient satisfaction within this wider context of changes in service delivery. Various models are examined that have attempted to define and interpret the idea of determining individual perceptions of the quality of health care delivered. Determinants of satisfaction are examined in relation to the literature on expectations, and demographic and psychosocial variables. These are distinguished from the multidimensional components of satisfaction as aspects of the delivery of care, identified by many authors. The review highlights the complexity and breadth of the literature in this field, the existence of which is often not acknowledged by researchers presenting the findings of studies.
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              Five laws for integrating medical and social services: lessons from the United States and the United Kingdom.

              W Leutz (1999)
              Because persons with disabilities (PWDs) use health and social services extensively, both the United States and the United Kingdom have begun to integrate care across systems. Initiatives in these two countries are examined within the context of the reality that personal needs and use of systems differ by age and by type and severity of disability. The lessons derived from this scrutiny are presented in the form of five "laws" of integration. These laws identify three levels of integration, point to alternative roles for physicians, outline resource requirements, highlight friction from differing medical and social paradigms, and urge policy makers and administrators to consider carefully who would be most appropriately selected to design, oversee, and administer integration initiatives. Both users and caregivers must be involved in planning to ensure that all three levels of integration are attended to and that the borders between medical and other systems are clarified.
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                Author and article information

                Contributors
                Journal
                Int J Integr Care
                Int J Integr Care
                1568-4156
                International Journal of Integrated Care
                Ubiquity Press
                1568-4156
                31 May 2016
                Apr-Jun 2016
                : 16
                : 2
                : 11
                Affiliations
                [-1]Department of Health Sciences, NTNU, Norwegian University of Science and Technology, Ålesund, Norway
                [-2]Department of Sociology and Social Work, Centre for Organization, Management & Administration, Aalborg University, Aalborg, Denmark
                Article
                10.5334/ijic.2226
                5015536
                27616966
                048e243c-05d8-4f0e-b8ed-3c2d7f8516e1
                Copyright: © 2016 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.

                History
                : 21 August 2015
                : 04 May 2016
                Categories
                Research and Theory

                Health & Social care
                elderly patients,integration,collaboration,interorganizational health,transitional care

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