ArticleBMC health services research2022
Hospital physicians' experiences and reflections on their work and role in relation to older patients' pathways - a qualitative study in two Norwegian hospitals.
Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- How hospital doctors respond to contextual factors revealed by older patients with heart failure in hospital interactions: an interaction-based study.BMC health services research · 2025Article
- Municipal healthcare providers' perceptions of reasons for frequent and unplanned hospital admissions among home-dwelling older adults: a Norwegian focus group study.BMC geriatrics · 2025Article
- Hospital nurses and physicians' experiences practicing patient safety work to recognize deteriorating patients: a qualitative study.BMC health services research · 2024Article
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Abstract
backgroundOlder patients are the most frequent users of initial hospital admissions and readmissions. Both hospital admission and discharge require communication and coordination between healthcare professionals within the hospital, and between professionals in hospitals and primary healthcare. We have identified few studies exploring hospital physicians' perspectives on older patients' pathways in the interface between hospital and primary healthcare services. The aim of this study was to explore hospital physicians' experiences and reflections on their work and role in relation to older patients' pathways between hospital and primary healthcare. Specifically, we focused on the challenges they faced and how they dealt with these in relation to admission and discharge, and their suggestions for service improvements that could facilitate older patients' pathway.
methodsWe used a qualitative approach, conducting individual in-depth interviews with 18 hospital physicians from two hospitals in eastern Norway. Data were analyzed using systematic text condensation, in line with a four-step prosedure developed by Malterud.
resultsThe participants emphasized challenges in the communication about patients across the two service levels. Moreover, they described being in a squeeze between prioritizing patients and trying to ensure a proper flow of patients through the hospital wards, but with restricted possibilities to influence on the admissions. They also described a frustration regarding the lack of influence on the healthcare delivery after discharge. The participants had various suggestions for service improvements which might be beneficial to older patients.
conclusionsThe results demonstrate that the hospital physicians perceived being squeezed between professional autonomy and limited capacity at the hospital, and between their medical judgement as a specialist and their power to decide on hospital admissions for old patients and also on the delivery of health care services to patients after discharge.
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