Continuity of long-term medication use after surgical hospital stay

Hach, Isabel; Maywald, Ulf; Meusel, Dirk; König, Jörg; Kirch, Wilhelm

doi:10.1007/s00228-005-0934-5

Cited by 11 publications

(11 citation statements)

References 22 publications

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“…This may indicate that some of the attending physicians focused on symptomatic treatment of the medical condition. Patients with ACS took an average of six medications and patients with stroke took an average of five medications, which is in the upper range reported in the literature (Hach et al 2005;Harder et al 2005). It was also found that polypharmacy can be caused by treatment according to evidence-based therapeutic guidelines, which is particularly problematic for elderly and multi-morbid patients (Meinertz and Kähler 2005).…”

Section: Discussionmentioning

confidence: 95%

“…As a result, modifications in pharmaceutical treatment were found to various degrees and at different stages in the course of continued medical care (Hach et al 2005;Himmel et al 2004;Taxis and Schneeweiss 2003). Inconsistency in prescription behaviour is especially problematic when dealing with medications with a proven benefit for preventing serious adverse health conditions.…”

Section: Introductionmentioning

confidence: 99%

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Changes in secondary pharmacological prevention of acute coronary syndromes and stroke after hospital discharge: a 6-month follow-up study of German primary care patients

et al. 2008

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Aim: This study examined modifications in secondary preventive medication between the time of hospital discharge (HD) and during a 6-month follow-up treatment of outpatients with acute coronary syndromes (ACS) and stroke. Subjects and methods: During a 6-month period, a health diary was completed on a weekly basis by 98 patients who were initially hospitalised with ACS and 29 patients with strokes in the Cologne area (Germany). Changes in medication between the time of HD and follow-up treatment (weeks 2, 12, and 24) were recorded. Results: On average, patients with ACS took six medications, whereas patients with stroke took five medications per day. ACS patients received beta-blockers (96%), lipid-lowering agents (80%), and angiotensin-converting enzyme (ACE) inhibitors (64%) at HD, and no changes in medication were made during follow-up treatment. However, there was a significant decrease in prescriptions of clopidogrel among ACS patients within 6 months, and about 13% of ACS patients did not receive an antiplatelet agent at any time. Stroke patients received beta-blockers (50%), lipid-lowering agents (67%), and antiplatelet agents, such as acetylsalicylic acid (57%) or clopidogrel (27%), at the time of HD, and no significant changes in medication were instituted during follow-up treatment. Conclusion: Treatment of ACS patients with the combination of acetylsalicylic acid and clopidogrel was insufficient, although it has been shown that this combination is highly effective in secondary prevention of ACS. Besides medical reasons, the cost-containment restrictions (“medication budget”) for German physicians might explain the observed failure of guideline-oriented medication. Furthermore, no changes in medications occurred regarding blood-pressure- and lipid-lowering agents

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Changes in secondary pharmacological prevention of acute coronary syndromes and stroke after hospital discharge: a 6-month follow-up study of German primary care patients

et al. 2008

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“…A lack of interorganizational collaboration was found to be associated with discontinuity of care, for instance, regarding pharmacotherapy (Adl et al, 2001;Hach, Maywald, Meusel, König, & Kirch, 2005). In studies conducted with hospitalized patients, perceived coordination and continuity of care were found to be a determinant of the overall evaluation of care (Berendsen, de Jong, Meyboom-de Jong, Dekker, & Schuling, 2009;Jenkinson et al, 2002).…”

Section: Previous Researchmentioning

confidence: 94%

Interorganizational relationships and hospital financial performance: a resource-based perspective

Gloede

Pulm

Hammer

et al. 2013

The Service Industries Journal

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This study follows a resource-based theory perspective and aims to analyze the interorganizational relationships between hospitals and outpatient physicians, and hospital financial performance. In the light of increasing interdependence among healthcare providers which has made the coordination of service provision more complex, such relationships could be considered a resource for hospitals that lead to higher performance. In this study, the results from a survey of medical directors were combined with financial performance indicators of their hospitals. The results show that having effective interorganizational relationships is positively associated with the hospital's profitability. This finding emphasizes the importance of an investment in interorganizational relationships from the hospital's point of view.

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“…In order to test this, the authors concentrated on the medication administered on admission to hospital and provided considerable evidence of changes in the prescriptions during the stay in hospital. Hach et al [16] show that hospitalization neither saves the ambulatory follow-up treatment nor is accompanied by a reduction in medication.…”

Section: Introductionmentioning

confidence: 99%

On the interdependence of ambulatory and hospital care in the German health system

et al. 2017

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For some considerable time now the interface between ambulatory and hospital care has been mooted as a cause of inefficiencies in the German health system and there have been calls for a softening of the strict separation between the two sectors. This debate emphasizes the need for detailed empirical information on the interdependence between the two sectors. Using extensive administrative data at the level of the 412 German counties for the years 2007 to 2009 and a simultaneous equation model which allows the numbers of ambulatory and hospital cases to be mutually interdependent, we examine the connection between ambulatory and hospital specialist care separately for ten medical specialties. The results show that the interdependence of ambulatory and hospital services is far from homogeneous. The relationship depends, on the one hand, on the specialty and, on the other, on the direction of the effect observed. This heterogeneity needs to be taken into account for cross-sector needs-based planning.

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Continuity of long-term medication use after surgical hospital stay

Abstract: The observed changes in medication after hospitalization can be only partially attributed to a successful surgical intervention and to the hospital stay. Those alterations seemed not to be initiated by the intention of saving costs.

Cited by 11 publications

References 22 publications

Changes in secondary pharmacological prevention of acute coronary syndromes and stroke after hospital discharge: a 6-month follow-up study of German primary care patients

Changes in secondary pharmacological prevention of acute coronary syndromes and stroke after hospital discharge: a 6-month follow-up study of German primary care patients

Interorganizational relationships and hospital financial performance: a resource-based perspective

On the interdependence of ambulatory and hospital care in the German health system

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