During the period of the survey there were 2,401 unique planned admissions at the hospital. A total of 603 surveys were returned. Due to significant missing data about their current technology use and preferences 78 surveys were removed. The results for this study included responses from 525 patients with a planned admission to the hospital. Table 1 provides the characteristics of the sample. There was an approximately equal distribution of male (n = 244, 51%) and female (n = 238, 49%) patients, and the majority (n = 294, 70%) were aged over 50 years and most (n = 503, 98%) spoke English at home. Many (n = 285, 54%) had completed vocational or postgraduate studies and a third (n =152, 33%) had an annual household income above 100,000 AUD. The majority lived with other people (n = 456, 89%), but did not have responsibilities for children (n = 393, 76%) or elders (n = 485, 94%) at home. Reasons for admission were for surgery (e.g., knee replacement, breast cancer surgery) (n = 326, 68%) or for investigational procedures and medical care (e.g., angiogram, cystoscopy) (n = 153, 32%). Patients were admitted for a variety of conditions including gastrointestinal (n = 111, 21%), orthopaedic (n = 142, 14%), cardiac (n = 75, 14%), and oncological (n = 41, 8%).
Patients reported using a range of technologies as part of their general day to day activities (Table 2). The most frequently reported use was mobile phone (n = 495, 97%), text messaging (n = 454, 93%), email (n = 452, 93%), and the internet/websites (n = 451, 93%). The least frequently used was online discussion groups or forums (n = 152, 40%). Patients also reported high use of technology to assist in managing their health (see Table 2). For example, the most frequently reported use was mobile phone (n = 365, 82%), internet/websites (n = 320, 78%), email (n = 325, 93%), a laptop or desktop computer (n = 317, 74%), and text messaging (n = 275, 76%). Using a tablet or mobile phone application to assist in managing health was the most frequently reported technology to be of interest to those not currently using (n = 70, 20%). However, across all technologies, more patients were not interested than those who were interested in using each technology.
Patient-ranked communication preferences regarding symptoms post-discharge from the hospital are presented in Table 3. For symptoms of little concern, telephoning the hospital was the most common first preference (n = 193, 37%), followed by attending the hospital in-person (n = 179, 34%). Approximately 30% (n = 160) of patients ranked a type of technology as their first preference for communication about symptoms that were of little concern. For symptoms of concern, in-person communication was the most common preference (n = 305, 58%), followed by communicating by telephone (n = 168, 32%). Communicating with any other technologies was the first preference by only 10% (n = 49) of respondents. In terms of the types of technology, the least common preferred option for both symptoms of low and higher concern was for online discussion forums.
Bivariate analyses (Table 4) identified significant associations between several variables. Age (p = .0001), condition requiring treatment (p = .02), admitting medical condition (p = .02), employment (p = .0001), and household income (p = .01) were associated with differing preferences for communicating about symptoms that were not of concern following hospital discharge. Type of condition requiring treatment was the only variable associated with preferences for communicating about symptoms that were of concern (p = .01).
In the multivariable analyses, after controlling for salient covariates (i.e., those identified through bivariate analyses as well as age and gender), the admitting condition, income, and age remained significantly associated with communication preferences about symptoms following hospital discharge (Table 5). Type of treatment received and employment were not included in the multivariable model because of the potential for multicollinearity with condition receiving treatment and annual household income, respectively. For symptoms not of concern, having either a cardiac or ‘other’ condition compared to having an orthopaedic condition was associated with increased preference for in-person communication than a telephone call (RRR 0.19; CI 0.08-0.45, RRR 0.44; CI 0.20, 0.98, respectively). Having a household income of more than 100,000 AUD per year was associated with increased preference for telephone and technology than in-person modes of communication about symptoms of low concern (RRR 2.43; CI 1.25, 4.74, RRR 2.09; CI 1.08, 4.07, respectively). In comparison to those aged between 18-30 years, those aged 66-80 years and those aged over 80 years had a greater preference for telephone than in-person to communicate about symptoms of concern (RRR 4.08; CI 1.11, 15.02; RRR 7.63; CI 1.64, 35.55, respectively). Lastly, patients with gastrointestinal conditions had a greater preference for in-person communication than using technology to communicate about symptoms of concern compared to patients with orthopaedic conditions (RRR 0.280; CI 0.086, 0.914).