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Resource Dependency and Discharge Planning in Metropolitan and Nonmetropolitan Hospitals

Indiana University School of Medicine

Neale Chumbler

Case Western Reserve University

Wendy Nadzam

Case Western Reserve University

This article investigates whether discharge planning procedures and discharge planners' perceptions of the availability of paid home care services vary according to the metropolitan or nonmetropolitan location of hospitals. Resource dependency theory suggests that hospital and community environments are likely to affect the discharge planning process through discharge planners'perceptions of the adequacy of resources in those environments. A stratified random sample of discharge planning coordinators in 60 metropolitan and 59 nonmetropolitan acute care hospitals in Ohio were sent questionnaires on the discharge and referral process of elderly patients. Findings indicate that discharge personnel of nonmetropolitan and large inner-city metropolitan hospitals are less likely than those of moderate-sized metropolitan hospitals to feel that an adequate amount of paid home care services is available in the community. Moreover, discharge departments of nonmetropolitan and large inner-city metropolitan hospitals are more likely to rely on patient financial information and informal care availability in discharge planning. Discharge departments in these hospitals also are more likely to train informal caregivers and maintain postdischarge contact.

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