Grant: Commonwealth Fund Dissemination Award 2015-2016

Good communication between patients and care providers is essential for patient-centered care. The association of patient experience and health outcomes is timely research topic. In the inpatient setting, two recent studies have shown that poor communication between patients and healthcare providers is a driver of preventable adverse events and readmissions. An international study of communication with patients at hospital discharge would allow for a valuable snapshot of where the Canadian health system may improve, while providing a comparison with its industrialized counterparts. Using data from the 2014 Commonwealth Fund International Health Policy (IHP) Survey of Older Adults, the objectives of the present study were to a) compare four aspects of discharge communication in 11 developed countries (including Canada), and b) to compare Canada and its industrialized counterparts in risk-adjusted analyses. The study sample was 5,974 adults (55 years and older) who were hospitalized overnight in the previous 2 years. Four questions pertaining to discharge communication comprised the outcome variables: 1) Receiving written information on what to do and what symptoms to watch out, 2) Having had follow-up arrangements made, 3) Discussing the purpose of taking each of your medications, and 4) Knowing who to contact with questions about your condition/treatment. Response frequencies and rankings for each outcome were tabulated by country. Multivariate logistic regression examined the association between country (Canada vs. others) and each outcome question, while controlling for a variety of demographic and clinical factors. The study will generate objective evidence to inform patient-centered care in Canada and abroad. This will assist in the design of tailored quality improvement efforts, and may help to reduce unplanned readmissions by emphasizing the importance of communication between patients and care providers at the time of hospital discharge.