Contextual Factors Affecting Continuity of Follow-Up Care After Hospital Discharge for Patients with Chronic Diseases in Sudan: A Qualitative Study with Causal Loop Diagram Insights
This study aims to identify factors influencing the continuity of follow-up care after hospital discharge from the perspectives of physicians and key healthcare stakeholders and map their interactions to facilitate understanding of dynamic relationships. We conducted audio-recorded semi-structured i...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2025-06-01
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| Series: | Health Services Insights |
| Online Access: | https://doi.org/10.1177/11786329251349916 |
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| author | Asma MohamedSharif Armin Gemperli |
| author_facet | Asma MohamedSharif Armin Gemperli |
| author_sort | Asma MohamedSharif |
| collection | DOAJ |
| description | This study aims to identify factors influencing the continuity of follow-up care after hospital discharge from the perspectives of physicians and key healthcare stakeholders and map their interactions to facilitate understanding of dynamic relationships. We conducted audio-recorded semi-structured interviews with 17 participants (10 medical doctors, 3 state key informants, and 4 federal key informants) in Khartoum State, Sudan. Data analysis included thematic analysis to identify the factors and purposive text analysis to develop a causal loop diagram. We identified 39 factors affecting the continuity of follow-up care from hospital to home, categorized into 5 challenges: follow-up care adherence, quality of pre-discharge patient education, efficiency of the referral system, primary healthcare center accessibility, and quality improvement efforts. The study identified 2 balancing loops and 5 reinforcement feedback loops affecting follow-up care post-hospital discharge. The low adherence to follow-up care proposes quality improvement efforts as a solution, however, the high workload, resource depletion, referral system inefficiency, and quality improvement stagnation reinforcing loops impede progress in this direction. We recommend enhancing pre-discharge patient education and using multisectoral approaches to improve primary healthcare, optimize referrals with digital tools, and address staff turnover, to strengthen follow-up care. |
| format | Article |
| id | doaj-art-e5daec8672cc4bf0bcbde0d50c69536a |
| institution | Kabale University |
| issn | 1178-6329 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Health Services Insights |
| spelling | doaj-art-e5daec8672cc4bf0bcbde0d50c69536a2025-08-20T03:32:07ZengSAGE PublishingHealth Services Insights1178-63292025-06-011810.1177/11786329251349916Contextual Factors Affecting Continuity of Follow-Up Care After Hospital Discharge for Patients with Chronic Diseases in Sudan: A Qualitative Study with Causal Loop Diagram InsightsAsma MohamedSharif0Armin Gemperli1Faculty of Health Sciences and Medicine, University of Lucerne, SwitzerlandCenter of Primary and Community Care, University of Lucerne, SwitzerlandThis study aims to identify factors influencing the continuity of follow-up care after hospital discharge from the perspectives of physicians and key healthcare stakeholders and map their interactions to facilitate understanding of dynamic relationships. We conducted audio-recorded semi-structured interviews with 17 participants (10 medical doctors, 3 state key informants, and 4 federal key informants) in Khartoum State, Sudan. Data analysis included thematic analysis to identify the factors and purposive text analysis to develop a causal loop diagram. We identified 39 factors affecting the continuity of follow-up care from hospital to home, categorized into 5 challenges: follow-up care adherence, quality of pre-discharge patient education, efficiency of the referral system, primary healthcare center accessibility, and quality improvement efforts. The study identified 2 balancing loops and 5 reinforcement feedback loops affecting follow-up care post-hospital discharge. The low adherence to follow-up care proposes quality improvement efforts as a solution, however, the high workload, resource depletion, referral system inefficiency, and quality improvement stagnation reinforcing loops impede progress in this direction. We recommend enhancing pre-discharge patient education and using multisectoral approaches to improve primary healthcare, optimize referrals with digital tools, and address staff turnover, to strengthen follow-up care.https://doi.org/10.1177/11786329251349916 |
| spellingShingle | Asma MohamedSharif Armin Gemperli Contextual Factors Affecting Continuity of Follow-Up Care After Hospital Discharge for Patients with Chronic Diseases in Sudan: A Qualitative Study with Causal Loop Diagram Insights Health Services Insights |
| title | Contextual Factors Affecting Continuity of Follow-Up Care After Hospital Discharge for Patients with Chronic Diseases in Sudan: A Qualitative Study with Causal Loop Diagram Insights |
| title_full | Contextual Factors Affecting Continuity of Follow-Up Care After Hospital Discharge for Patients with Chronic Diseases in Sudan: A Qualitative Study with Causal Loop Diagram Insights |
| title_fullStr | Contextual Factors Affecting Continuity of Follow-Up Care After Hospital Discharge for Patients with Chronic Diseases in Sudan: A Qualitative Study with Causal Loop Diagram Insights |
| title_full_unstemmed | Contextual Factors Affecting Continuity of Follow-Up Care After Hospital Discharge for Patients with Chronic Diseases in Sudan: A Qualitative Study with Causal Loop Diagram Insights |
| title_short | Contextual Factors Affecting Continuity of Follow-Up Care After Hospital Discharge for Patients with Chronic Diseases in Sudan: A Qualitative Study with Causal Loop Diagram Insights |
| title_sort | contextual factors affecting continuity of follow up care after hospital discharge for patients with chronic diseases in sudan a qualitative study with causal loop diagram insights |
| url | https://doi.org/10.1177/11786329251349916 |
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