Comparison between the Chief Care Manager and the Normal Care Manager on Hospitalization and Discharge Coordination Activities in Japan: An Online Cross-Sectional Study of Care Managers in Aichi Prefecture
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Participants
2.3. Data Collection
2.4. Definition of Terms
2.4.1. Hospitalization Support
2.4.2. Discharge Support
2.5. Explanation of Survey Items
2.5.1. Key Statistics
2.5.2. Hospitalization/Discharge Support Activities
2.5.3. Psychological Information
2.6. Statistical Analyses
2.7. Survey Method and Ethical Considerations
3. Results
3.1. Participants’ Characteristics
3.2. Survey Results
4. Discussion
4.1. Care Managers’ Assistance to Patients during Their Hospitalization/Discharge and Related Activities: “Hospitalization/Discharge Support in the Community”
4.2. Society’s Needs for Care Managers and Chief Care Manager Certification and the Behavioral Change Factors Ofcare Managers
4.3. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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No. | Questions | The Survey of Respondent |
---|---|---|
Q1 | Years of experience as a care manager | All respondents ※ |
Q2 | Background licenses | All respondents |
Q3 | Age group | All respondents ※ |
Q4 | Presence or absence of chief care manager certificate | All respondents |
Q5 | With or without hearing patient “values,” “desired medical care,” and “goals in life” on a daily basis | All respondents |
Q6 | With or without having been involved in the hospitalization and discharge support of their patients during the three months from May 2021 to July 2021 | All respondents |
Q7 | How many patients were involved in your hospitalization support during the three months from May 2021 to July 2021 | Only respondents of Q6 |
Q8 | Did you provide information to medical institutions on patient “values,” “hope for medical treatment,” and “goals in life,” in the hospitalization support even once during the 3 months from May 2021 to July 2021? | Only respondent(s) (≥1) of Q7 |
Q9 | Degree of your confidence regarding providing hospitalization support | Only respondent(s) (≥1) of Q7 ※ |
Q10 | Degree of your anxiety about providing hospitalization support | Only respondent(s) (≥1) of Q7 ※ |
Q11 | How many patients were involved in your discharge support during the three months from May 2021 to July 2021 | All respondents |
Q12 | How many times had you been contacted by hospital about holding a predischarge conference among the patients involved in discharge support during the three months from May 2021 to July 2021 | All respondents |
Q13 | Degree of your confidence related to providing discharge support | Only respondent(s) (≥1) of Q12 ※ |
Q14 | Degree of anxiety about providing discharge support | Only respondent(s) (≥1) of Q12 ※ |
Q15 | Did you provide information to medical institutions on patient “values,” “hope for medical treatment,” and “goals in life” in the discharge support even once during the 3 months from May 2021 to July 2021? | All respondents |
Q16 | Had you reported the status of patients to medical institutions within 1 month after the discharge of patients who were involved in your discharge support, during the 3 months from May 2021 to July 2021? | All respondents |
With Chief Care Manager Certificate | Without Chief Care Manager Certificate | χ2-Value | p-Value | ||||
---|---|---|---|---|---|---|---|
N | % | N | % | ||||
301 | 67.2 | 147 | 32.8 | ||||
Age group | (n = 448) | 301 | 67.2 | 147 | 32.8 | 39.581 | <0.001 * |
20–29 years | 0 | 0 | 1 | 100 | |||
30–39 years | 4 | 19.0 | 17 | 81.0 | |||
40–49 years | 82 | 58.2 | 59 | 41.8 | |||
50–59 years | 140 | 74.1 | 49 | 25.9 | |||
60–69 years | 70 | 79.5 | 18 | 20.5 | |||
≥70 years | 5 | 62.5 | 3 | 37.5 | |||
Number of years of experience | (n = 448) | 301 | 67.2 | 147 | 32.8 | 158.575 | <0.001 * |
≤4 years | 3 | 4.5 | 64 | 95.5 | |||
5–9 years | 60 | 61.2 | 38 | 38.8 | |||
10–14 years | 108 | 82.4 | 23 | 17.6 | |||
15–19 years | 95 | 87.2 | 14 | 12.8 | |||
≥20 years | 35 | 81.4 | 8 | 18.6 | |||
With a nursing license (n = 78) The subjects were care managers who answered that they had a nursing license. | 60 | 76.9 | 18 | 23.1 | 4.060 | 0.044 * | |
Number of care managers who collected information about “values,” “desired medical care,” and “goals in life” of their patients through daily interactions (n = 422) | 288 | 68.2 | 134 | 31.8 | 3.699 | 0.054 | |
Number of care managers who were involved in the hospitalization and discharge of their patients (n = 360) The subjects were care managers who answered that they were involved in the hospitalization and discharge of patients. | 246 | 68.3 | 114 | 31.7 | 1.091 | 0.296 | |
Whether or not care managers provided information about patients’ “values,” “desired medical care,” and “goals in life” to hospitals in hospitalization on support at least once (n = 284) The subjects were care managers who answered that they provided information about patient’s “values,” “desired medical care,” and “goals in life” to hospitals during hospitalization at least once. | 196 | 69.0 | 88 | 31.0 | 1.772 | 0.183 | |
Number of care managers who provided information about patients’ “values,” “desired medical care,” and “goals in life” to hospitals in discharge support at least once (n = 260) The subjects were care managers who answered that they had provided hospital staff with information on the patient’s “values,” “desired medical care,” and “goals in life” at least once when supporting a patient’s discharge. | 176 | 67.7 | 84 | 32.3 | 0.072 | 0.789 | |
Number of care managers who provided patient information to hospitals within one month of discharge (n = 179) The subjects were care managers who answered that they provided the patient’s information to the hospitals within 1 month of discharge. | 128 | 71.5 | 51 | 28.5 | 2.525 | 0.112 |
With a Chief Care Manager Certificate | Without a Chief Care Manager Certificate | χ2-Value | p-Value | ||||
---|---|---|---|---|---|---|---|
N | % | N | % | ||||
Confidence level in hospitalization support | (n = 336) The subjects were only care managers who answered that they were involved in patients’ hospitalization and discharge support during the 3 months from May 2021 to July 2021. | 227 | 109 | 18.269 | 0.001 * | ||
Very confident | 2 | 0.9 | 0 | 0 | |||
Confident | 28 | 12.3 | 6 | 5.5 | |||
Moderately confident | 139 | 61.2 | 52 | 47.7 | |||
Moderately not confident | 58 | 25.6 | 50 | 45.9 | |||
Not confident | 0 | 0 | 0 | 0 | |||
Not confident at all | 0 | 0 | 1 | 0.9 | |||
Anxiety level regarding hospitalization support | (n = 336,448) | 227 | 109 | 13.765 | 0.017 | ||
Not anxious at all | 7 | 3.1 | 2 | 1.8 | |||
Not anxious | 27 | 11.9 | 7 | 6.4 | |||
Moderately not anxious | 85 | 37.4 | 28 | 25.7 | |||
Moderately anxious | 97 | 42.7 | 58 | 53.2 | |||
Anxious | 9 | 4.0 | 11 | 10.1 | |||
Very anxious | 2 | 0.9 | 3 | 2.8 | |||
Confidence level in discharge support | (n = 217) The subjects were only care managers who answered that they were contacted by the hospital about holding a predischarge conference for the patients involved in discharge support during the 3 months from May 2021 to July 2021. | 156 | 61 | 13.552 | 0.009 * | ||
Very confident | 2 | 1.3 | 0 | 0 | |||
Confident | 14 | 9.0 | 1 | 1.6 | |||
Moderately confident | 90 | 57.6 | 27 | 44.3 | |||
Moderately not confident | 48 | 30.8 | 29 | 47.5 | |||
Not confident | 2 | 1.3 | 4 | 6.6 | |||
Not confident at all | 0 | 0 | 0 | 0 | |||
Anxiety level regarding discharge support | (n = 217) The subjects were only care managers who answered that they were contacted by the hospital about holding a predischarge conference for the patients involved in discharge support during the 3 months from May 2021 to July 2021. | 156 | 61 | 7.121 | 0.13 | ||
Not anxious at all | 3 | 1.9 | 0 | 0 | |||
Not anxious | 17 | 10.9 | 2 | 3.3 | |||
Moderately not anxious | 56 | 35.9 | 20 | 32.8 | |||
Moderately anxious | 72 | 46.2 | 32 | 52.5 | |||
Anxious | 8 | 5.1 | 7 | 11.4 | |||
Very anxious | 0 | 0 | 0 | 0 |
Number of patients for whom care managers provided hospitalization support (n = 336) The subjects were care managers who answered ≥1 to Q7 (How many patients were involved in your hospitalization support during the 3 months from May 2021 to July 2021?). | Number of times contacted about “predischarge conferences” held by hospitals (n=2174) The subjects were care managers who answered ≥1 to Q12 (How many times had you been contacted by the hospital about holding a predischarge conference for the patients involved in discharge support during the 3 months from May 2021 to July 2021?). | |||||||||||
n | Median | Minimum | Maximum | SD ※ 1 | IQR ※ 2 | n | Median | Minimum | Maximum | SD ※ 1 | IQR ※ 2 | |
With chief care manager certificate | 226 | 2 | 1 | 12 | 2.013 | 3 | 156 | 1.5 | 1 | 17 | 2.037 | 1 |
Without chief care manager certificate | 106 | 2 | 1 | 10 | 2.061 | 2 | 61 | 1 | 10 | 10 | 1.707 | 1 |
Number of patients for whom care managers provided hospitalization support (n = 336) The subjects were care managers who answered ≥1 to Q7 (How many patients were involved in your hospitalization support during the 3 months from May 2021 to July 2021?). | Number of times contacted about “predischarge conferences” held by hospitals (n = 217) The subjects were care managers who answered ≥1 to Q12 (How many times were you contacted by the hospital about holding a predischarge conference for the patients involved in discharge support during the 3 months from May 2021 to July 2021?). | |||||||||||
n | Median | Minimum | Maximum | SD ※ 1 | IQR ※ 2 | n | Median | Minimum | Maximum | SD ※ 1 | IQR ※ 2 | |
With a nursing license | 61 | 2 | 1 | 7 | 1.588 | 3 | 39 | 1 | 10 | 10 | 1.709 | 2 |
Without a nursing license | 275 | 2 | 1 | 12 | 2.114 | 3 | 178 | 1 | 1 | 17 | 1.999 | 1 |
Number of care managers who collected information about “values,” “desired medical care,” and “goals in life” of their patients through daily interactions (n = 422) The subjects were care managers who answered that they collected information about “values,” “desired medical care,” and “goals in life” of their patients through daily interactions. | Number ofpatients for whom care managers provided hospitalization support (n = 336) The subjects were care managers who answered ≥1 to Q7 (How many patients were involved in your hospitalization support during the 3 months from May 2021 to July 2021?). | Number of times contacted about the “predischarge conferences” held by hospitals (n = 217) The subjects were care managers who answered ≥1 to Q12 (How many times had you been contacted by hospital about holding a predischarge conference for the patients involved in discharge support during the 3 months from May 2021 to July 2021?). | ||||
r※ 1 | p-Value | r※ 1 | p-Value | r※ 1 | p-Value | |
With/without chief care manager certificate | 0.091 | 0.055 | 0.121 | 0.026 * | 0.06 | 0.381 |
With/without nursing license | 0.064 | 0.179 | −0.055 | 0.311 | −0.001 | 0.989 |
Collection of information about patients’ “values,” “desired medical care,” and “goals in life” through daily interactions (n = 422) The subjects were care managers who answered that they collected information about “values,” “desired medical care,” and “goals in life” of their patients through daily interactions. | Involvement in hospitalization (n = 336) The subjects were care managers who answered ≥1 to Q7 (How many patients were involved in your hospitalization support during the 3 months from May 2021 to July 2021?). | Number of times contacted about “predischarge conferences” held by hospitals (n= 2174) The subjects were care managers who answered ≥1 to Q12 (How many times were you contacted by hospital about holding a predischarge conference for the patients involved in discharge support during the 3 months from May 2021 to July 2021?). | ||||||||||
n | OR ※ 3 | 95% CI ※ 2 | p-Value | n | OR ※ 3 | 95% CI ※ 2 | p-Value | n | OR ※ 3 | 95% CI ※ 2 | p-Value | |
With chief care manager certificate | 288 | 1.444 | 0.549–3.797 | 0.456 | 227 | 0.519 | 0.267–1.006 | 0.052 | 156 | 1.320 | 0.805–2.163 | 0.271 |
Without chief care manager certificate | 134 | 109 | 61 |
Confidence in hospitalization support (n = 227) The subjects were care managers who answered that they were confident in providing hospitalization support among care managers who answered that they were involved in hospitalization support in the 3 months from May 2021 to July 2021. | No anxiety for hospitalization support (n = 208) The subjects were care managers who answered “no anxiety” about hospitalization support among all respondents. | Care managers provided information about patients’ “values,” “desired medical care,” and “goals in life” to hospitals for hospitalization support at least once (n = 284) The subjects were care managers who provided information about patients’ “values,” “desired medical care,” and “goals in life” to hospitals for hospitalization support at least once among care managers who answered that they were involved in hospitalization support during the 3 months from May 2021 to July 2021. | ||||||||||
n | OR ※ 3 | 95% CI ※ 2 | p-Value | n | OR ※ 3 | 95% CI ※2 | p-Value | n | OR※ 3 | 95% CI ※ 2 | p-Value | |
With chief care manager certificate | 169 | 2.005 | 1.162–3.461 | 0.013 * | 154 | 1.32 | 0.83–2.098 | 0.24 | 196 | 1.374 | 0.688–2.747 | 0.368 |
Without chief care manager certificate | 58 | 54 | 88 |
Confidencein discharge support (n = 134) The subjects were care managers who answered “confident” in discharge support among care managers who answered that they were contacted by the hospital about holding a predischarge conference for the patients involved in discharge support during the 3 months from May 2021 to July 2021. | No anxiety in discharge support (n = 98) The subjects were care managers who answered “not anxious” in discharge support among care managers who answered that they were contacted by the hospital about holding a predischarge conference for the patients involved in discharge support during the 3 months from May 2021 to July 2021. | |||||||
n | OR ※3 | 95% CI ※2 | p-value | n | OR ※3 | 95% CI ※2 | p-value | |
With chief care manager certificate | 106 | 2.268 | 1.103–4.6665 | 0.026* | 76 | 1.441 | 0.705–2.946 | 0.317 |
Without chief care manager certificate | 28 | 22 | ||||||
Care managers provided information about patients’ “values,” “desired medical care,” and “goals in life” to hospitals in discharge support at least once (n = 260) The subjects were care managers who answered that they provided information about patients’ “values,” “desired medical care,” and “goals in life” to hospitals in discharge support at least once among all respondents. | Number of care managers who provided patient information to hospitals within one month of discharge (n = 179) The subjects were care managers who answered that they provided patient information to hospitals within 1 month of discharge of the patient involved in discharge support during the 3 months from May 2021 to July 2021 among all respondents. | |||||||
n | OR ※3 | 95% CI ※2 | p-value | n | OR ※3 | 95% CI ※2 | p-value | |
With chief care manager certificate | 176 | 0.946 | 0.596–1.501 | 0.812 | 128 | 1.167 | 0.731–1.863 | 0.511 |
Without chief care manager certificate | 84 | 51 |
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Goto, Y.; Miura, H.; Ito, N. Comparison between the Chief Care Manager and the Normal Care Manager on Hospitalization and Discharge Coordination Activities in Japan: An Online Cross-Sectional Study of Care Managers in Aichi Prefecture. Int. J. Environ. Res. Public Health 2022, 19, 12122. https://doi.org/10.3390/ijerph191912122
Goto Y, Miura H, Ito N. Comparison between the Chief Care Manager and the Normal Care Manager on Hospitalization and Discharge Coordination Activities in Japan: An Online Cross-Sectional Study of Care Managers in Aichi Prefecture. International Journal of Environmental Research and Public Health. 2022; 19(19):12122. https://doi.org/10.3390/ijerph191912122
Chicago/Turabian StyleGoto, Yuko, Hisayuki Miura, and Naomi Ito. 2022. "Comparison between the Chief Care Manager and the Normal Care Manager on Hospitalization and Discharge Coordination Activities in Japan: An Online Cross-Sectional Study of Care Managers in Aichi Prefecture" International Journal of Environmental Research and Public Health 19, no. 19: 12122. https://doi.org/10.3390/ijerph191912122