| Background:Hepatic cirrhosis is known as a kind of common chronic progressive diffuse liver disease. Hepatitis B is prevalent in China and the case fatality rate of hepatic cirrhosis is high. Especially when the liver function goes into decompensated period, patients often repeatedly are in hospital due to reasons such as ascites. This seriously increased the pressure and economic burden of the patients individuals, families and society. There have been a number of studies confirm that, discharge planning is the key to provide patients continuity of care cost-effectively from hospital to home. However, related study is still in its infancy in mainland China, and a unified programme or policy guideline has not been established. Particularly the special discharge planning programme for patients with liver cirrhosis hasn’t been reported in the literatures in Chinese or English.Objectives:To establish a operable discharge planning programme which is based on the level of hospital. And to evaluate its clinical effectiveness for hospital inpatients with hepatic cirrhosis on length of hospital stay, hospital cost, hospital readmission, disease prognosis, quality of life, patients’satisfaction and so on.Methods:One hundred and twenty patients with liver cirrhosis, which conformed to the inclusion criteria and were admitted into the liver and spleen medicine in the clinical medical college of Yangzhou university from September 2013 to August 2014, were randomly divided into the intervention group (n=60) and the control group (n=60). The intervention group received usual care and discharge planning services which were according to the discharge planning programme; while the control group received usual care only. Correspondingly, the outcomes data of patients in two groups were collected respectively from the aspects of baseline situation, length of stay, hospital cost, readmission rate, readmission interval time, all-cause mortality, liver function, quality of life and satisfaction of nursing services at the time of group admission, hospital discharge,1-month and 3-month after discharge. The data were inputted and verified in Epidata 3.1 software. And statistic analyses were performed in SPSS 19.0 to explore the effectiveness of application with discharge planning programme on hospital inpatients with hepatic cirrhosis.Results:Finally, a total of 91 patients completed the researches with 46 cases in the intervention group and 45 cases in control group. The results showed that:(1) There were no statistically significant difference (P>0.05) on the outcomes of length of stay and hospital cost compared intervention group to control group.(2) As to the readmission rate, there was no significant difference between the two groups at 1-month after discharge (P>0.05); but significant difference were found at 3-month after discharge (P＜0.05).(3) The readmission interval in 1-month (P<0.05) and 1 to 3 months (P<0.01) after discharge between the two groups were all significantly longer than that of control group.(4) About the all-cause mortality and liver function improvement, there were no statistically significant difference (P>0.05) at hospital discharge,1-month or 3-month after discharge.(5) After the discharge planning intervention, the patients’ satisfaction and overall scores, physical and mental health scores of the quality of life were significantly higher than that of control group (P<0.05); and there were no significant difference between the two groups in the score of social relation and the surrounding of quallity of life (P>0.05).Conclusions:(1) Clinical application of discharge planning programme in patients with liver cirrhosis in hospital can significantly reduce the readmission rate and extend the readmission interval.(2) Clinical application of discharge planning programme can improve the level of the patients’ physical and mental health, and increase the quality of life.(3) Clinical application of discharge planning programme can significantly enhance the patients’ satisfaction with nursing services. |
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