ArticleBMC health services research2018
Exploring physicians' decision-making in hospital readmission processes - a comparative case study.
Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- How do primary care clinicians approach hospital admission decisions for people in the final year of life? A systematic review and narrative synthesis.Palliative medicine · 2024Pooled it
- Influence of Previous Emergency Department Visit Information on Care of Current Patients.The western journal of emergency medicine · 2025Article
- Occupational stress among Norwegian physicians: A literature review of long-term prospective studies 2007-2019.Scandinavian journal of public health · 2025Review
- Primary care gatekeeping during the COVID-19 pandemic: a survey of 1234 Norwegian regular GPs.BJGP open · 2024Article
- Article
- Hospital physicians' experiences and reflections on their work and role in relation to older patients' pathways - a qualitative study in two Norwegian hospitals.BMC health services research · 2022Article
- Delivering exceptionally safe transitions of care to older people: a qualitative study of multidisciplinary staff perspectives.BMC health services research · 2020Article
- Article
- Life satisfaction in Norwegian medical doctors: a 15-year longitudinal study of work-related predictors.BMC health services research · 2019Article
- Hospital physicians' views on discharge and readmission processes: a qualitative study from Norway.BMJ open · 2019Article
- Nursing home leaders' and nurses' experiences of resources, staffing and competence levels and the relation to hospital readmissions - a case study.BMC health services research · 2018Article
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4 authors.
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Abstract
backgroundHospital readmissions is an increasingly serious international problem, associated with higher risks of adverse events, especially in elderly patients. There can be many causes and influential factors leading to hospital readmissions, but they are often closely related, making hospital readmissions an overall complex area. In addition, a comprehensive coordination reform was introduced into the Norwegian healthcare system in 2012. The reform changed the premises for readmissions with economic incentives enhancing early transfer from secondary to primary care, making research on readmissions in the municipalities more urgent than ever. General practitioners (GPs) and nursing home physicians, have traditionally held a gatekeepers function in hospital readmissions from the municipal healthcare service, as they are the main decision-makers in questions of hospital readmissions. Still, the GPs' gatekeeper function is an under-investigated area in hospital readmission research. The aim of the study was to increase knowledge about factors that lead to hospital readmissions among elderly in municipal healthcare, with special attention to GPs' and nursing home physicians' decision making.
methodThe study was conducted as a comparative case study. Two municipalities affiliated with the same hospital, but with different readmission rates were recruited. Twenty GPs and nursing home physicians from each municipality were recruited and interviewed. Forty hours of observation were conducted during the huddles in one long-term and one short-term nursing home in each municipality.
resultsSeven themes describing how different factors influence physicians' decision-making in the hospital readmission process in two municipalities were identified. Poor communication, continuity and information flow account for hospital readmissions in both municipalities. Several factors, including nurse staffing and competence, patients and their families, time constraints and experience affected physicians' decision-making.
conclusionCommunication, continuity and information flow contributed to hospital readmissions in both municipalities. The cross-case analysis revealed slight differences between municipalities. More research focusing on GPs' and nursing home physicians' decision-making, nursing home nurses and home care nurses' experience of hospital readmissions and discharges is needed.
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