大学病院における改訂版退院支援スクリーニング票の妥当性の検証

discharge planning

看護総合科学研究会誌

The purpose of the present study was to examine the validity of a revised screening tool for identifying patients who might require discharge planning at a university hospital. The original screening tool contained the following seven predictors based on elderly patients' needs for discharge planning: functional and mental status, medical treatment, living situation, arrangement for residence after discharge, problems regarding care at home, and application for Long-term Care Insurance. Total scores ranged from 0 to 26 and patients with scores greater than 10 were considered high-risk patients who should be referred to the discharge planning team. In the revised version, an age item was added and the contents of each predictor were modified concretely. The screening tool was completed by 435 patients over the age of 20 years who were hospitalized in a university hospital. The results indicated that among patients who scored more than 10 points, a high proportion were discharged to a place other than their homes or received discharge planning. Furthermore, when the cut-off value of the screening tool was set at 10 points (total score range: 0 to 28), the sensitivity for "high-risk patients", i.e., those who were discharged to places other than their homes or received discharge planning was 77.3%, with as pecificity of 84.3%. The present results suggest that this revised screening tool could be used to identify "high-risk patients" at a university hospital and is valid for clinical use.