PATIENT-PHYSICIAN COMMUNICATION AT HOSPITAL DISCHARGE AND PATIENTS UNDERSTANDING OF THE POSTDISCHARGE TREATMENT PLAN

Background: The quality of discharge planning is an important determin ant of patient outcomes following hospital discharge. Patients often r eport inadequate discussion prior to discharge regarding major element s of the postdischarge treatment plan, including medication and daily activities. Objective: To determine whether this apparent lack of comm unication might be the result of differing perceptions on the part of patients and physicians regarding the patients' understanding of the t reatment plan. Methods: We surveyed 99 patients and their attending ph ysicians. All patients had been discharged recently from an academic m edical center with the diagnosis of acute myocardial infarction or pne umonia. We asked both patients and physicians about time spent prior t o discharge discussing the postdischarge treatment plan and the patien ts' understanding of this plan. McNemar test was used to determine whe ther responses of patients and physicians differed. Results: Physician s reported spending more time discussing postdischarge care than did p atients (P=.10). Physicians believed that 89% of patients understood t he potential side effects of their medications, but only 57% of patien ts reported that they understood (P<.001). Similarly, physicians belie ved that 95% of patients understood when to resume normal activities, while only 58% of patients reported that they understood (P<.001). Con clusions: Physicians overestimate patients' understanding of the postd ischarge treatment plan. Steps should be taken to improve communicatio n about postdischarge treatment.