ArticlePloS one2020
Investigating discharge communication for chronic disease patients in three hospitals in India.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Patient reported measures of continuity of care and health outcomes: a systematic review.BMC primary care · 2024Pooled it
- Patient Experiences of Hospital Care in the Context of Comprehensive Care Delivery: A Mixed Method Study.Journal of advanced nursing · 2025Article
- One template does not fit all: where next to improve hospital discharge communication to primary care?Primary health care research & development · 2025Article
- Article
- Urban Indian healthcare referral system: A qualitative exploration from the physicians' perspectives.PloS one · 2025Article
- Health literacy and behaviors influencing blood sugar level control among type 2 diabetes patients in primary care units, Thailand: A cross-sectional study.F1000Research · 2022Article
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Authors and funding
10 authors.
Funding
Abstract
objectivesPoor discharge communication is associated with negative health outcomes in high-income countries. However, quality of discharge communication has received little attention in India and many other low and middle-income countries. PRIMARY
objectiveTo investigate verbal and documented discharge communication for chronic non-communicable disease (NCD) patients. SECONDARY
objectiveTo explore the relationship between quality of discharge communication and health outcomes.
methods
designProspective study.
settingThree public hospitals in Himachal Pradesh and Kerala states, India.
participants546 chronic NCD (chronic respiratory disease, cardiovascular disease or diabetes) patients. Piloted questionnaires were completed at admission, discharge and five and eighteen-week follow-up covering health status, discharge communication practices and health-seeking behaviour. Logistic regression was used to explore the relationship between quality of discharge communication and health outcomes. OUTCOME MEASURES: PRIMARY: Patient recall and experiences of verbal and documented discharge communication. SECONDARY: Death, hospital readmission and self-reported deterioration of NCD/s.
resultsAll patients received discharge notes, predominantly on sheets of paper with basic pre-printed headings (71%) or no structure (19%); 31% of notes contained all the following information required for facilitating continuity of care: diagnosis, medication information, lifestyle advice, and follow-up instructions. Patient reports indicated notable variations in verbal information provided during discharge consultations; 50% received ongoing treatment/management information and 23% received lifestyle advice. Within 18 weeks of follow-up, 25 (5%) patients had died, 69 (13%) had been readmitted and 62 (11%) reported that their chronic NCD/s had deteriorated. Significant associations were found between low-quality documented discharge communication and death (AOR = 3.00; 95% CI 1.27,7.06) and low-quality verbal discharge communication and self-reported deterioration of chronic NCD/s (AOR = 0.46; 95% CI 0.25,0.83) within 18-weeks of follow-up.
conclusionsSub-optimal discharge practices may be compromising continuity and safety of chronic NCD patient care. Structured protocols, documents and training are required to improve discharge communication, healthcare integration and NCD management.
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