HEALTH CHECK #6. Hospital to Home A pain for some

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1 HEALTH CHECK # Hospital to Home A pain for some The sixth Medibank Health Check is an independent survey of 1,510 Australians concerning their views on the experience of leaving hospital and transitioning back to home. Hospital to home experience The vast majority of people described their experience of leaving hospital as a positive one. However almost one in five (19 per cent) of people described the experience in negative and indeed worrying terms. How would you describe your experience of being discharged from hospital (1074 respondents, 1899 responses) Happy to leave & recover at home Prepared & ready to manage health & recovery Confident with managing health & recover Confused about what needs to be done Unprepared & unsure of the recovery process at home Unsupported & concerned about the recovery process Other Not applicable 7% 7% 5% 1% 1% 23% 23% 33% 0% 5% 10% 15% 20% 25% 30% 35%

2 Expectation versus reality There was a significant gap between expectation and reality what people viewed as important when leaving hospital and the actual experience. The widest gap related to getting a written discharge plan with 86 per cent saying it is important when leaving hospital and only 49 per cent reporting they received one. Many people also felt their opinions and preferences were not taken into account when the decision to be discharged was made and only 68 per cent felt that they were properly advised of the warning signs to monitor after leaving hospital. Of particular concern is that nearly 20 per cent did not understand when to take prescribed drugs when they left hospital. Experience vs importance of services after discharge from hospital I/they knew when to take any prescribed medications I/they understood my/their responsibilities for a healthy recovery on leaving hospital I/they had been given the information I/they needed to manage my/their health after leaving hospital I/they had been advised on what to do if a problem arises I/they had follow up appointments with a health practitioner already scheduled for me/them The health professional discharging me/them knew my/their case My/their GP knew my/their case I/they had been advised of the warning symptoms I/they should monitor My/their preferences were taken into account around when to be discharged I/they had a written plan from the hospital of what I am/they are supposed to do 49% 57% 94% 83% 76% 94% 76% 94% 75% 94% 71% 89% 71% 91% 70% 91% 68% 93% 87% 86% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Important when recovering from a hospital stay at home (n=1510, % saying extremely important and important) Experience of you or family member or friend discharged from hospital (n=1074, % saying 'yes' the following happened)

3 Responsibility and confidence in managing health The key finding here is that although 72 per cent of people said they wanted to take responsibility for their own health, only 56 per cent said they were comfortable doing so, which represents a significant gap between what people want and what they are comfortable doing. Furthermore, only 57 per cent of people said they understood what the medication did for them and 38 per cent knew of the treatments available if they had health problems. Thinking about managing your health, how do you feel about the following statements? (1510 Responses) True of me Somewhat true of me Somewhat untrue of me Untrue of me I am the person who is responsible for taking care of my health 72% 24% 3% 1% I am confident that I can follow through on minor medical treatments at home 63% 31% 5% 1% When I take prescribed medication I understand what the medication does 57% 35% 7% 2% I am comfortable managing my own health 56% 37% 6% 1% I am confident that I can tell my doctor concerns even when he or she does not ask 55% 35% 8% 2% I know what treatments are available if/when I have any health problems 38% 48% 12% 2%

4 Attitudes to coordinated after hospital care When asked for their opinion of planned and coordinated after hospital care, such as a care plan and assistance with medicines and follow up appointments, the response was overwhelmingly positive with only five per cent saying they saw no need for such a service. Attitude to a coordinated after hospital care program (1510 responses) 5% I welcome the service 28% 11% 56% I wish I or my relative had it when last in hospital I believe it would improve the recovery process I really don t see a need for such a service

5 Conclusion The key finding of Medibank Health Check #6 is that people believe there is something wrong with the hospital to home transition. The Health Check reveals that some people are feeling confused, unsupported and unprepared when leaving hospital. The things they see as important to a successful recovery are not being provided and although they want to take responsibility for the management of their health, they do not feel comfortable and confident enough to do so. The impacts of this reverberate across the health sector. Medibank statistics show that in 2013, over 6,000 Medibank members had an unplanned re-admission to hospital within 28 days of their original admission. This pushed Medibank benefit outlay costs up by over $42million and, more importantly, created unnecessary inconvenience, discomfort and potentially serious health consequences for impacted patients. The results of the sixth Medibank Health Check provides consumer validation for Medibank s CareTransition program. About the Medibank Health Check This Medibank Health Check survey, undertaken in May 2015, is part of the quarterly health check series focusing on health or wellbeing issues, where the involvement of the health services sector may be required. The Medibank Health Check aims to inform debate around such issues and help address emerging health concerns. The after hospital experience was chosen for our sixth Medibank Health Check because we wanted to find out: How people would describe their or a close friend or relatives experience leaving hospital and returning to home; What they saw as important when leaving hospital; What they experienced when leaving hospital; and Their thoughts on an after hospital service. About CareTransition The CareTransition program complements the hospital discharge process, addressing the care needs of those most at risk of unplanned re-admissions to hospital. The program assists patients transition to their home and community setting. The program does this through helping patients to better understand their health condition and become active participants in their health care. At its core, the objectives of the CareTransition program are to: Increase knowledge, skills and confidence in managing their health; Increase physical and mental wellbeing and quality of life; Reduce hospital re-admissions rates; Reduce benefit outlay costs; and Enhance member experience and satisfaction

6 Infographics

7 Medibank Health Check #6 - Questionnaire 1. Which statement best describes your experience with hospitals in Australia? (select as many as apply to you) I have had a close family member stay in hospital in the past three years I have been admitted to hospital in the past three years I have not been admitted to hospital in the last three years In the past three years I have had to be re-admitted to hospital soon after being discharged In the past three years I have had a close family member readmitted to hospital soon after discharge 2. If you or a close family member or friend have been in hospital in the past three years, how would you describe the experience of being discharged from hospital? (Choose as many as apply to you. Choose Not applicable if this question does not apply to you) Prepared and ready to manage the recovery process Confident with managing health and recovery Happy to leave and recover at home Unprepared and unsure of the recovery process at home Confused about what needed to be done Unsupported and concerned about the recovery process Other (please state) Not applicable 3. When you or your family member or friend were discharged from hospital in the last three years do you recall any of the following happening? (Yes, No, Uncertain) My/their preferences were taken into account around when to be discharged I/they had been given the information I needed to manage my health after leaving hospital I/they had been advised of the warning symptoms I should monitor My/their GP knew my case The health professional discharging me/them knew my case I/they had follow up appointments with a health practitioner already scheduled for me I/they knew when to take any prescribed medications I/they had a written plan from the hospital of what I am supposed to do I/they understood my responsibilities for a healthy recovery on leaving hospital I/they had been advised on what to do if a problem arises 4. What would be most important to you when recovering from a hospital stay at home? (Scale: Extremely Important, Important, unimportant, no need) My preferences have been taken into account around when to be discharged I have been given the information I need to manage my health after leaving hospital I have been advised of the warning symptoms I should monitor My GP knows my case I will have regular follow up visits at home The health professional discharging me knows my case I can have access to a 24/7 help line I can have access to a 24/7 doctor I have follow up appointments with a health practitioner already scheduled for me I know when to take any prescribed medications I have a written plan from the hospital of what I am supposed to do I understand my responsibilities for a healthy recovery on leaving hospital

8 I have been advised on what to do if a problem arises 5. A significant challenge for health care in Australia is ensuring a safe and healthy transition from hospital to ongoing recovery at home. This can often avoid re-admission to hospital. One solution is for better planned and coordinated after hospital care with such features as scheduled follow up appointments, visits at home and on call medical support. What best describes your attitude to such a service? (Choose one) I welcome the service I wish I or my relative had it when last in hospital I believe it would improve the recovery process I really don t see a need for such a service. 6. Thinking about managing your own health, how do you feel about the following statements? (Scale: True of me, Somewhat True, Somewhat untrue, Untrue of me) I am comfortable managing my own health I know what treatments are available if/when I have any health problems When I take prescribed medication I understand what the medication does I am confident that I can follow through on minor medical treatments at home I am confident that I can tell my doctor concerns even when he or she does not ask I am the person who is responsible for taking care of my health