Hospitalization and post-discharge care in South Africa: A critical event in the continuum of care.

OBJECTIVES:The purpose of this prospective cohort study is to characterize the event of acute hospitalization for people living with and without HIV and describe its impact on the care continuum. This study describes care-seeking behavior prior to an index hospitalization, inpatient HIV testing and...

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Main Authors: Cody Cichowitz, Rachael Pellegrino, Katlego Motlhaoleng, Neil A Martinson, Ebrahim Variava, Christopher J Hoffmann
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2018-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0208429
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author Cody Cichowitz
Rachael Pellegrino
Katlego Motlhaoleng
Neil A Martinson
Ebrahim Variava
Christopher J Hoffmann
author_facet Cody Cichowitz
Rachael Pellegrino
Katlego Motlhaoleng
Neil A Martinson
Ebrahim Variava
Christopher J Hoffmann
author_sort Cody Cichowitz
collection DOAJ
description OBJECTIVES:The purpose of this prospective cohort study is to characterize the event of acute hospitalization for people living with and without HIV and describe its impact on the care continuum. This study describes care-seeking behavior prior to an index hospitalization, inpatient HIV testing and diagnosis, discharge instructions, and follow-up care for patients for patients being discharged from a single hospital in South Africa. METHODS:A convenience sample of adult patients was recruited from the medical wards of a tertiary care facility. Baseline information at the time of hospital admission, subsequent diagnoses, and discharge instructions were recorded. Participants were prospectively followed with phone calls for six months after hospital discharge. Descriptive analyses were performed. RESULTS:A total of 293 participants were enrolled in the study. Just under half (46%) of the participants were known to be living with HIV at the time of hospital admission. Most participants (97%) were given a referral for follow-up care; often that appointment was scheduled within two weeks of discharge (64%). Only 36% of participants returned to care within the first month, 50% returned after at least one month had elapsed, and 14% of participants did not return for any follow up. CONCLUSIONS:Large discrepancies were found between the type of post-discharge follow-up care recommended by providers and what patients were able to achieve. The period of time following hospital discharge represents a key transition in care. Additional research is needed to characterize patients' risk following hospitalization and to develop patient-centered interventions.
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spelling doaj.art-a39cea321c564a67a46eefa30c0e60a62022-12-21T21:31:28ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-011312e020842910.1371/journal.pone.0208429Hospitalization and post-discharge care in South Africa: A critical event in the continuum of care.Cody CichowitzRachael PellegrinoKatlego MotlhaolengNeil A MartinsonEbrahim VariavaChristopher J HoffmannOBJECTIVES:The purpose of this prospective cohort study is to characterize the event of acute hospitalization for people living with and without HIV and describe its impact on the care continuum. This study describes care-seeking behavior prior to an index hospitalization, inpatient HIV testing and diagnosis, discharge instructions, and follow-up care for patients for patients being discharged from a single hospital in South Africa. METHODS:A convenience sample of adult patients was recruited from the medical wards of a tertiary care facility. Baseline information at the time of hospital admission, subsequent diagnoses, and discharge instructions were recorded. Participants were prospectively followed with phone calls for six months after hospital discharge. Descriptive analyses were performed. RESULTS:A total of 293 participants were enrolled in the study. Just under half (46%) of the participants were known to be living with HIV at the time of hospital admission. Most participants (97%) were given a referral for follow-up care; often that appointment was scheduled within two weeks of discharge (64%). Only 36% of participants returned to care within the first month, 50% returned after at least one month had elapsed, and 14% of participants did not return for any follow up. CONCLUSIONS:Large discrepancies were found between the type of post-discharge follow-up care recommended by providers and what patients were able to achieve. The period of time following hospital discharge represents a key transition in care. Additional research is needed to characterize patients' risk following hospitalization and to develop patient-centered interventions.https://doi.org/10.1371/journal.pone.0208429
spellingShingle Cody Cichowitz
Rachael Pellegrino
Katlego Motlhaoleng
Neil A Martinson
Ebrahim Variava
Christopher J Hoffmann
Hospitalization and post-discharge care in South Africa: A critical event in the continuum of care.
PLoS ONE
title Hospitalization and post-discharge care in South Africa: A critical event in the continuum of care.
title_full Hospitalization and post-discharge care in South Africa: A critical event in the continuum of care.
title_fullStr Hospitalization and post-discharge care in South Africa: A critical event in the continuum of care.
title_full_unstemmed Hospitalization and post-discharge care in South Africa: A critical event in the continuum of care.
title_short Hospitalization and post-discharge care in South Africa: A critical event in the continuum of care.
title_sort hospitalization and post discharge care in south africa a critical event in the continuum of care
url https://doi.org/10.1371/journal.pone.0208429
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