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    Emergency department visits following discharge: Implications for healthcare management
    (ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2020) Kaya, Sidika; Guven, Gulay Sain; Teles, Mesut; Aydan, Seda; Kar, Ahmet; Bahcecioglu, A. Begum; Senturk, Esra Firat
    Objective: This study aimed to reveal the frequency of emergency department (ED) visits within 7 and 30 days after discharge and to identify the factors affecting these ED visits. Methods: A total of 1570 patients discharged from the internal medicine wards of a university hospital in Turkey within 1 year were included in this prospective cohort study. Multiple logistic regression analyses were used to identify the factors affecting ED visits. Results: Of the patients, 1.3% visited the ED within the first 7 days after discharge and 5.2% within 30 days. Multivariable analyses showed that the probability of an ED visit within 30 days was 1.83 (95% CI 1.09-3.08; p = 0.023) times higher for male patients and 2.15 (95% CI 1.00-4.60; p = 0.049) times higher for patients with intensive care unit (ICU) stay before discharge. The probability of an ED visit increased by 1.25 (95% CI 1.11-1.42, p < 0.001) times for every 1-point increase in the comorbidity score. The costs of ED visits within 0-7 days were lower than the costs within 8-30 days (p = 0.001). Conclusion: Innovative approaches targeting discharge planning and postdischarge care for patients with high comorbidity scores and ICU use during index hospitalization could reduce ED visits within 30 days after discharge.
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    Patients' readiness for discharge: Predictors and effects on unplanned readmissions, emergency department visits and death
    (Wiley, 2018) Kaya, Sidika; Guven, Gulay Sain; Aydan, Seda; Kar, Ahmet; Teles, Mesut; Yildiz, Ahmet; Toka, Onur
    AimTo determine the variables that affect patients' perceptions about their readiness for discharge and to elucidate the effects of these perceptions on patient outcomes such as unplanned readmission to the hospital, emergency department visits and death within 30days after discharge. BackgroundIn recent years, it has become even more important to assess patients' readiness for discharge as patients tend to be discharged more quickly. MethodsFor the determination of patients' self-assessment, the Readiness for Hospital Discharge Scale/Short Form was utilized. This 1-year prospective cohort study included 1,601 patients. Data were analysed using a chi-square test, Mann-Whitney U test, univariate logistic regression analysis and multiple logistic regression analysis. ResultsThe results of multiple logistic regression analysis revealed that age, sex, marital status, educational status, presence of someone to help at home after discharge and length of stay were predictors of patients' readiness for hospital discharge. Furthermore, being unready for discharge increased the risk of 30day unplanned readmission and 30day death. ConclusionsConsidering these predictors, patients' perceptions of readiness for discharge must be assessed before deciding to discharge them. Implications for Nursing ManagementNurse managers can consider the predictors of patients' readiness for discharge, thus the risk of unplanned readmission and death may be reduced.