A Focus Group Interview with Health Professionals: Establishing Efficient Transition Care Plan for Older Adult Patients in Korea

BackgroundEven though transition care can affect functional status and quality of life after acute hospitalization for older adults, less is known on problems associated with discharge planning in Korean acute hospitals. We aimed to investigate barriers and possible solutions on transfer planning of complex older patients in this study.MethodsWe used focus group interview with application of framework analysis. Twelve physicians providing inpatient care from 6 different institutions in Korea participated for the interview. Facilitating questions were extracted from 2 roundtable meetings prior to the main interview. From transcribed verbatim, themes were constructed from corresponding remarks by participants. ResultsWe revealed two main domains of the barrier which included multiple subdomains for each of them. First domain was a patient factor barrier, a composite of misperception of medical provider’s intentions, incomprehension of the healthcare system, and communication failure between the caregivers or decision makers. Second domain, institutional factors included different fee structures across the different levels of care, high barrier to accessing health service in tertiary hospitals or to be referred to, hardship of communication between institutions, and insufficient subacute rehabilitation service across the country. ConclusionsThrough the interview, physicians in the field recognized barriers of smooth transition care process from tertiary level hospitals to community care especially for older adults. Participants emphasized both the patients and hospital sides of adjustment on behaviors, communication, and greater attention for what really matters for the individuals during the transition period.