Unmet needs for visiting nurse services among older people after hospital discharge and related factors in Japan: Cross-sectional survey

Aim: Studies have suggested that some home care recipients have unmet needs for visiting nurse services. In particular, such needs are greater just after hospital discharge than at other times. Thus, there is concern that there exist unmet needs for visiting nurse services among patients after hospital discharge. The purpose of this study was to investigate the current situation of unmet needs for visiting nurse services among older patients discharged from acute hospitals. Methods: This was a cross-sectional correlation study. Participants were patients aged 65 years or over who had been discharged from the general units in all hospitals in four prefectures in Japan after a hospital stay of 14 days or more. Nursing staff gathered the patients' information and assessed unmet needs for visiting nurse services after discharge. Results: There were 1594 eligible participants; 190 (11.9%) utilized visiting nurse services after discharge and 87 (5.4%) were judged to have no visiting nurse services despite a need for such services. Need for assistance in activities of daily living, presence of a respiratory disease, need for continued medical/nursing care after discharge, inadequate capacity for family caregiving, and implementation of discharge planning were related to use of, and need for, visiting nurse services. Conclusion: After controlling for other factors, implementation of discharge planning determined the utilization of, and the need for, nursing care after discharge. Therefore, an adequate discharge planning screening system is necessary.