What is the clinical evidence from this study?

Study design: Cohort. Population: Hospital discharge in older adults (n=263). Intervention: General practice discharge summary processing. Primary outcome: Failure to complete requested discharge actions (errors).

What question did this study set out to answer?

The aim is to explore errors and harms linked to discharge summaries and their associations with readmissions in older adults.

April 4, 2026British Journal of General Practice1 citationsOpen Access

General practice follow-up after hospital discharge in older adults: Retrospective records analysis

NKNaomi KlepaczUniversity of Warwick ALAnnabelle LongUniversity of Warwick ZSZakia ShariffUniversity of Warwick

Key Result

General practice processing of hospital discharge summaries for older adults resulted in 21.3% of requested actions not being completed, leading to errors in 12.5% of patients and harm in 4.4%.

Key Points

The aim is to explore errors and harms linked to discharge summaries and their associations with readmissions in older adults.
Conducted a retrospective cohort study using electronic health records from seven general practices.
Reviewed records of 263 patients aged ≥65 years discharged between October 2022 and 2023.
Analyzed post-discharge healthcare utilization, error rates, harms, and readmission within 90 days.
Utilized multivariable logistic regression to identify predictors of errors, harms, and readmission.
70.7% of discharged patients accessed post-discharge care.
17.5% of patients experienced readmissions within 90 days.
21.3% of requested actions in discharge summaries were not completed, primarily related to medications.
12.5% of patients experienced errors, with 4.4% suffering harms, most of which were preventable.

Study Design

Type

Cohort (n=263)

Multicenter

Yes

Structured PICO

Population

263 patients aged ≥65 years discharged from hospital between October 2022-2023, mean age 77.4, 53% male, from seven general practices in the West Midlands, UK.

Intervention

General practice follow-up and discharge summary processing

Outcome

Post-discharge healthcare utilisation and costs, frequency and type of discharge actions, error rates (failures to complete requested actions), harms (severity, attribution, preventability), and 90-day readmissions within 90 days of dischargesafety

General practice processing of hospital discharge summaries for older adults has a high rate of incomplete actions (21.3%), leading to preventable harms and readmissions, particularly in vulnerable patients with dementia.

Limitations

Clinically appropriate decisions to override or defer requests may have gone unrecorded in the retrospective records.
Subjectivity remains in the independent assessment of harms despite using standardised tools.
Individual-level deprivation could not be assessed as patient postcodes were not extracted for confidentiality reasons.
General practice contact data were limited to the first six contacts due to the intensity of manual extraction.

Abstract

Background: Most hospital admissions are older patients, who are more likely to be medically complex. Primary care risks after hospital discharge and readmission trajectories are relatively unexplored. Aim: To estimate the frequency and nature of errors and harms linked to discharge summary processing in general practice for patients aged ≥65 years and explore associations with readmission and healthcare utilisation from a novel primary care data source. Design and Setting: Retrospective cohort study using electronic health records (EHRs) from seven purposively sampled general practices in the West Midlands, UK. Method: We reviewed EHRs for 263 patients aged ≥65 years discharged between October 2022-2023. Outcomes included post-discharge healthcare utilisation and costs, frequency and type of discharge actions, error rates (failures to complete requested actions), harms (severity, attribution, preventability), and 90-day readmissions. Multivariable logistic regression identified predictors of errors, harms and readmission. Results: 186/263 discharged patients (70.7%) accessed post-discharge care; with 47/263 patients 17.5% (95% CI: 13.7-23.0%) having related readmissions within 90 days. The 263 discharge summaries requested 551 actions; 21.3% were not completed, over half involving medications. 12.5% of patients experienced error, 4.4% experienced harm. Most harms were preventable and resulted in hospital readmission. Error/harm disproportionately affected patients with dementia or recorded carer. Conclusion: General practice needs to review their processes for responding to patient discharge information in order to improve patient safety post-discharge. Further research into tools to assist practice with transitions is warranted.

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