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Lehn SF, Zwisler AD, Pedersen SGH, et al. Patient-specific versus Organisational Barriers to Program Adherence: A Multivariate Analysis. Int J Integr Care. 2019;19(1):7doi: 10.5334/ijic.4212.
Lehn, S. F., Zwisler, A. D., Pedersen, S. G. H., Gjørup, T., & Thygesen, L. C. (2019). Patient-specific versus Organisational Barriers to Program Adherence: A Multivariate Analysis. International journal of integrated care, 19(1), 7. https://doi.org/10.5334/ijic.4212
Lehn, Sara Fokdal, et al. "Patient-specific versus Organisational Barriers to Program Adherence: A Multivariate Analysis." International journal of integrated care vol. 19,1 (2019): 7. doi: https://doi.org/10.5334/ijic.4212
Lehn SF, Zwisler AD, Pedersen SGH, Gjørup T, Thygesen LC. Patient-specific versus Organisational Barriers to Program Adherence: A Multivariate Analysis. Int J Integr Care. 2019 Mar 15;19(1):7. doi: 10.5334/ijic.4212. PMID: 30918479; PMCID: PMC6427061.
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Int J Integr Care. 2019 Mar 15;19(1):7. doi: 10.5334/ijic.4212.

Patient-specific versus Organisational Barriers to Program Adherence: A Multivariate Analysis.

International journal of integrated care

Sara Fokdal Lehn, Ann-Dorthe Zwisler, Solvejg Gram Henneberg Pedersen, Thomas Gjørup, Lau Caspar Thygesen

Affiliations

  1. Department of Medicine, Holbæk University Hospital, Smedelundsgade 60, Holbæk, DK.
  2. Knowledge Centre for Rehabilitation and Palliative Care, Odense University hospital and University of Southern Denmark, Vestergade 17, Nyborg, DK.
  3. Danish Knowledge Centre for Rehabilitation and Palliative Care, University of Southern Denmark and Odense University hospital, Vestergade 17, Nyborg, DK.
  4. Department of Medicine, Geriatric section, Holbæk University Hospital, Smedelundsgade 60, Holbæk, DK.
  5. Emergency Clinic, Gentofte Hospital, Kildegårdsvej 28, Hellerup, DK.
  6. National Institute of Public Health, University of Southern Denmark, Studiestræde 6, København, DK.

PMID: 30918479 PMCID: PMC6427061 DOI: 10.5334/ijic.4212

Abstract

INTRODUCTION: This article explores the influence of patient-specific and organisational factors on adherence to program guidelines in an integrated care program targeting older patients.

METHODS: The integrated care program aimed to offer post-discharge follow-up visits by a municipality nurse and the general practitioner to frail older patients after discharge from hospital. Adherence was measured as

RESULTS: We found substantial lack of adherence in both steps of the program: 69% adherence in step 1 and 54% adherence in step 2. In step 1, adherence was related to hospital, and receiving municipal home care prior to admission. In step 2, level of adherence varied according to municipality, the type of general practitioner and the patient's gender.

CONCLUSION: We found that adherence was strongly related to organisational factors. Adherence differed significantly at all organisational levels (hospital, municipality, general practice), thus indicating challenges in the vertical integration of care. Gender influenced adherence as the only patient-related factor.

Keywords: adherence; implementation; integrated care program; older patients; organizational factors; patient-specific factors

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