16 The readmission rate was partly influenced by inadequate inpatient care and by a lack of discharge planning.
The lack of discharge continuity places pressure on service providers who have to make assessments without important information regarding diagnoses made and treatments provided in prison.
At the same time, this lack of discharge coordination is puzzling given the high performance of the Dutch primary care gatekeeper system, in which less than 5% of patients are admitted to the hospital without a GP referral.
Five independent factors of dissatisfaction were identified: no information provided to GPs at patient admission, poor quality of family reception in the ICU, the ICU's family-contact person's identity and/or function is unclear, lack of family information, and lack of discharge report.
Of interest, when the 102 participants excluded from the predictive model due to lack of discharge data were compared respectively to the rest of the patients for the variables listed on Table 1, three tests were statistically different: Barthel mean (85.45 vs. 88.76 p < 0.001), TUG mean (29.39 vs. 26.17 p < 0.001) and Berg mean (37.37 vs. 39.60 p < 0.001), albeit of minimal clinical significance.
Record the type and consistency of discharge or note the lack of discharge.
Lack of clear admission and discharge criteria and decision-making by physicians with no knowledge of the status of the unit created most of the problems.
Lack of complete data included in discharge summaries of women and neonates not only hampered the audit, but present considerable challenges (including further vaccination and contact tracing of families) to those responsible for the on-going care and management of the mother and infant, such as general practitioners, primary health care services, paediatricians and hepatologists.
The lack of a discharge summary, or errors and omissions in the discharge medicines information provided, may be even more significant because of poorer health status, low health literacy [ 12] and the low access to medical practitioners and community pharmacy services [ 17, 18].
