Key result
General practice discharge summary processing misses ~21% of requested actions for older adults, linked to harm.
Why the study?
Older hospitalized patients are often medically complex, but primary care risks following hospital discharge and readmission trajectories remain relatively unexplored.
Cohort (n=263)
Yes
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.
May warrant improved GP systems for discharge summaries to prevent harm; extends mixed equivocal evidence requiring interventional trials.
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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Klepacz et al. (2026) conducted a cohort in Hospital discharge in older adults (n=263). General practice discharge summary processing was evaluated on Failure to complete requested discharge actions (errors). 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%.
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