Entlassmanagement

Deimel, Dominik; Müller, Marie-Luise

doi:10.1055/b-002-25586

Cited by 5 publications

(1 citation statement)

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“…Studies suggest that a lack of knowledge about a patient's treatment history can lead to polymedication, duplicate testing and inadequate follow-up care after discharge from hospital [3][4][5]. Gaps in care after discharge and in ambulatory follow-up, such as non-adherence to pharmacological treatment prescribed in hospital, a lack of timely medication review and missed follow-up visits, increase the risk of hospital readmission [6,7]. Moreover, there is evidence that good continuity of ambulatory care can reduce the overall risk of hospitalisation, particularly of that due to ambulatory-care-sensitive indications [8][9][10].…”

Section: Background: Study Objectives and Trial Designmentioning

confidence: 99%

Improving the continuity and coordination of ambulatory care through feedback and facilitated dialogue—a study protocol for a cluster-randomised trial to evaluate the ACD study (Accountable Care in Germany)

Sundmacher

Flemming

Leve

et al. 2021

Trials

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Background Patients in Germany are free to seek care from any office-based physician and can always ask for multiple opinions on a diagnosis or treatment. The high density of physicians and the freedom to choose among them without referrals have led to a need for better coordination between the multiple health professionals treating any given patient. The objectives of this study are to (1) identify informal networks of physicians who treat the same patient population, (2) provide these physicians with feedback on their network and patients, using routine data and (3) give the physicians the opportunity to meet one another in facilitated network meetings. Methods The Accountable Care Deutschland (ACD) study is a prospective, non-blinded, cluster-randomised trial comprising a process and economic evaluation of informal networks among 12,525 GPs and office-based specialists and their 1.9 million patients. The units of allocation are the informal networks, which will be randomised either to the intervention (feedback and facilitated meetings) or control group (usual care). The informal networks will be generated by identifying connections between office-based physicians using complete datasets from the Regional Associations of Statutory Health Insurance (SHI) Physicians in Hamburg, Schleswig Holstein, North Rhine and Westphalia Lip, as well as data from three large statutory health insurers in Germany. The physicians will (a) receive feedback on selected indicators of their own treatment activity and that of the colleagues in their network and (b) will be invited to voluntary, facilitated network meetings by their Regional Association of SHI physicians. The primary outcome will be ambulatory-care-sensitive hospitalisations at baseline, at the end of the 2-year intervention period, and at six months and at 12 months after the end of the intervention period. Data will be analysed using the intention-to-treat principle. A pilot study preceded the ACD study. Discussion Cochrane reviews show that feedback can improve everyday medical practice by shedding light on previously unknown relationships. Providing physicians with information on how they are connected with their colleagues and what the outcomes are of care delivered within their informal networks can help them make these improvements, as well as strengthen their awareness of possible discontinuities in the care they provide. Trial registration German Clinical Trials Register DRKS00020884. Registered on 25 March 2020—retrospectively registered.

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Section: Background: Study Objectives and Trial Designmentioning

confidence: 99%

Improving the continuity and coordination of ambulatory care through feedback and facilitated dialogue—a study protocol for a cluster-randomised trial to evaluate the ACD study (Accountable Care in Germany)

Sundmacher

Flemming

Leve

et al. 2021

Trials

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Discharge and Transition Management in Integrated Care

Urbanski¹,

Reichert

Amelung

2021

Handbook Integrated Care

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Discharge management in German hospitals for cognitively impaired, older people—a scoping review

Schumacher-Schönert

Wucherer

Nikelski³

et al. 2020

Z Gerontol Geriat

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Zusammenfassung Hintergrund In deutschen Krankenhäusern sind etwa 40 % aller Patienten über 65 Jahre kognitiv beeinträchtigt. Für diese ist es besonders wichtig, dass die Überleitung in die Häuslichkeit möglichst bruchlos und vollumfänglich bedarfsgerecht organisiert ist. Ziel der Arbeit Ziel der Arbeit ist es, einen systematischen Überblick über Evidenz des Entlassmanagements (EM) bei Menschen mit kognitiven Beeinträchtigungen (MmkB) oder Demenz (MmD) zu geben. Ferner soll geprüft werden, ob sich, darauf aufbauend, die Notwendigkeit eines sektorenübergreifenden Konzeptes ergibt. Material und Methoden Anhand eines Scoping Review wurden n = 102 Publikationen identifiziert, von denen n = 6 in die Analysen eingingen. Ergebnisse Der Artikel gibt eine Übersicht über die aktuelle Versorgung von MmkB in deutschen Akutkrankenhäusern. Generelle Informationen zum EM im Krankenhaus wurden in 3 der 6 eingeschlossenen Arbeiten gegeben. Informationen zu einem speziellen Entlass- und Versorgungsmanagement für MmkB und MmD waren in 5 von 6 Arbeiten enthalten. Diskussion Der Artikel illustriert bestehende Versorgungslücken von älteren MmkB an der Schnittstelle des Entlassmanagements und zeigt die Notwendigkeit neuer Versorgungsmodelle. Inwieweit diese strukturell, prozessual und systemisch in die Regelversorgung eingebettet und finanziert werden können, ist bislang offen und unerforscht.

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Entlassmanagement

Cited by 5 publications

References 0 publications

Improving the continuity and coordination of ambulatory care through feedback and facilitated dialogue—a study protocol for a cluster-randomised trial to evaluate the ACD study (Accountable Care in Germany)

Improving the continuity and coordination of ambulatory care through feedback and facilitated dialogue—a study protocol for a cluster-randomised trial to evaluate the ACD study (Accountable Care in Germany)

Discharge and Transition Management in Integrated Care

Discharge management in German hospitals for cognitively impaired, older people—a scoping review

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