PREDICTION MODEL FOR DELAYED FOLLOW-UP VISITS AMONG GERIATRIC PATIENTS AFTER HOSPITAL DISCHARGE BASED ON DIGITAL HEALTH LITERACY, FAMILY SUPPORT, AND MEDICATION REGIMEN COMPLEXITY AT A HOSPITAL IN MEDAN CITY
DOI:
https://doi.org/10.61677/jth.v4i1.262Keywords:
Geriatric patients, delayed follow-up, digital health literacy, family support, prediction model.Abstract
Delayed post-discharge follow-up among geriatric patients may compromise continuity of care and increase the risk of adverse health outcomes. Early identification of patients at high risk is essential to facilitate timely interventions. This study aimed to develop and validate a prediction model for delayed follow-up visits among hospitalized geriatric patients. A cross-sectional study was conducted among 263 geriatric patients discharged from a general hospital in Medan, Indonesia. Digital health literacy, family support, and medication regimen complexity were assessed using validated instruments. Multivariable logistic regression was performed to identify independent predictors of delayed follow-up, and model performance was evaluated using the area under the receiver operating characteristic curve (AUROC) and the Hosmer–Lemeshow goodness-of-fit test. Delayed post-discharge follow-up occurred in 34.6% of participants. Low digital health literacy (adjusted OR = 2.87), poor family support (adjusted OR = 1.93), and high medication regimen complexity (adjusted OR = 3.76) were independently associated with delayed follow-up. The final prediction model demonstrated good discrimination with an AUROC of 0.821 (95% CI: 0.769–0.873) and satisfactory calibration (Hosmer–Lemeshow p = 0.617), indicating good predictive performance. Low digital health literacy, poor family support, and high medication regimen complexity are significant predictors of delayed post-discharge follow-up among geriatric patients. The proposed prediction model may serve as a practical screening tool to identify patients requiring targeted discharge planning and transitional care interventions, thereby improving continuity of care and supporting healthy ageing.
References
Ağan, F. Z., Ci̇ndoğlu, Ç., Dalbaşı, M., & Ağan, V. (2026). Association of frailty index with handgrip strength and biochemical parameters in geriatric patients. BMC Geriatrics, 26(1). https://doi.org/10.1186/s12877-026-07419-5
Arima, Y., Sumitomo, K., Miyauchi, Y., et al. (2025). Pharmacist's support in the transition from hospital to home care in patients with multiple medications: Avoidance of fragmentation of care. Cureus, 17(7), e87751. https://doi.org/10.7759/cureus.87751
Febriyanti, A. P., Atmaja, R. R. D., Oktaviani, H. C., & Wijaya, D. (2023). Analisis peresepan polifarmasi pada pasien geriatri dengan diabetes melitus tipe 2 berdasarkan Beers Criteria 2023. Jurnal Mandala Pharmacon Indonesia, 9(2), 145-156. https://doi.org/10.35311/jmpi.v9i2.423
Giehl, C., Chatsatrian, M., Vollmar, H. C., Busse, T. S., Bosompe, J., Rasche, P., Dieris-Hirche, J., Pape, M., Juckel, G., Haussleiter, I., Timmesfeld, N., Mai, A., Wirth, R., & Otte, I. C. (2024). Exploring accessibility, user experience and engagement of digital media among older patients with depression: A pilot and observational screening study protocol of the DiGA4Aged study. BMJ Open, 14(11), e086779. https://doi.org/10.1136/bmjopen-2024-086779
Happe, J. P., Katthagen, J. C., Fischhuber, K., Marschall, U., Faldum, A., Raschke, M. J., Koeppe, J., & Stolberg-Stolberg, J. (2026). The importance of comprehensive geriatric assessment in predicting the outcome of patients with proximal humerus fractures. Aging Clinical and Experimental Research, 38(1). https://doi.org/10.1007/s40520-026-03357-9
Huang, J. W., Yang, Y. F., Gao, X. S., & Xu, Z. H. (2026). Five-factor modified frailty index is a reliable indicator for predicting postoperative mortality in geriatric intertrochanteric fracture patients aged 80 years and older: a case-control study. BMC Musculoskeletal Disorders, 27(1). https://doi.org/10.1186/s12891-026-09549-8
Kachentawa, K. (2024). The role of digital media and technologies and eHealth literacy in elderly holistic healthcare practices: A literature review. NIDA Development Journal, 64(1), 66–95. https://doi.org/10.14456/ndj.2024.3
Kara, K., Tural, S., Sokucu, S. N., Altin, S., & Bolat, E. (2026). Single-center experience with hemoptysis in geriatric patients. BMC Geriatrics, 26(1). https://doi.org/10.1186/s12877-026-06968-z
Kaya, F., Özayar, E., Özcan, A. T. D., Uçar, M., & Öztürk, L. (2026). How are cognitive functions affected by different sedation methods in geriatric endoscopic retrograde cholangiopancreatography patients? BMC Anesthesiology, 26(1). https://doi.org/10.1186/s12871-025-03555-4
Lu, Y., et al. (2024). An automated strategy to calculate medication regimen complexity. AMIA Annual Symposium Proceedings, 2024, 789-798. https://pubmed.ncbi.nlm.nih.gov/38222413/
Lu, J., Huang, J., Guo, Y., Wu, Q., Jiang, Z., Yang, T., Bian, J., & Bo, L. (2026). Comparative analysis of six large language models in perioperative decision support for geriatric patients with multimorbidity: a three-dimensional evaluation framework. BMC Anesthesiology, 26(1). https://doi.org/10.1186/s12871-025-03605-x
Poojar, B., Kamath, A., Rao, S. B., Ullal, S. D., Ramapuram, J., Yadiyal, M. B., & Shenoy, A. K. (2024). A prospective study of the medication regimen complexity index and hospitalization due to adverse drug reactions among people living with HIV. Medicina, 60(10), 1705. https://doi.org/10.3390/medicina60101705
Raboti, Z., Rösler, A., Lindner, R., Gallinat, J., & Schneider, B. C. (2026). Exploring the concept of a “friendly relationship to death” in geriatric patients. BMC Geriatrics, 26(1). https://doi.org/10.1186/s12877-025-06670-6
Sawadogo, A. R., Lagrange, A., Bosetti, A., Rudelle, K., Dumoitier, N., Nys, J. F., Gayot, C., & Tchalla, A. (2026). Cost-effectiveness of emergency department-based vs mobile geriatric care models for older patients. BMC Geriatrics, 26(1). https://doi.org/10.1186/s12877-026-06975-0
Toporowski, G., Mueller-Mai, C. M., Rascher, K., & Wiedemann, J. (2026). Impact of SARS-CoV-2 subvariants on postoperative outcomes in geriatric hip fracture patients – a multinational multicentre study. BMC Geriatrics, 26(1). https://doi.org/10.1186/s12877-025-06840-6
Urquiza, M., Fernández, N., Arrinda, I., Espin, A., García-García, J., Rodriguez-Larrad, A., & Irazusta, J. (2025). Predictors of hospital readmission, institutionalization, and mortality in geriatric rehabilitation following hospitalization according to admission reason. Journal of Geriatric Physical Therapy, 48(1), 5-13. https://doi.org/10.1519/JPT.0000000000000414
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 JTH: Journal of Technology and Health
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
