title: Improving continuity of patient care across sectors: study protocol of a quasi-experimental multi-centre study regarding an admission and discharge model in Germany (VESPEERA)
creator: Forstner, Johanna
creator: Straßner, Cornelia
creator: Kunz, Aline
creator: Uhlmann, Lorenz
creator: Freund, Tobias
creator: Peters-Klimm, Frank
creator: Wensing, Michel
creator: Kümmel, Stephanie
creator: El-Kurd, Nadja
creator: Rück, Ronja
creator: Handlos, Bärbel
creator: Szecsenyi, Joachim
subject: ddc-610
subject: 610 Medical sciences Medicine
description: Background: Hospitalisations are a critical event in the care process. Insufficient communication and uncoordinated follow-up care often impede the recovery process of the patient resulting in a high number of rehospitalisations and increased health care costs. The overall aim of this study is the development, implementation and evaluation of a structured programme (VESPEERA) to improve the admission and discharge process.    Methods: We will conduct an open quasi-experimental multi-centre study with four intervention arms. A cohort selected from insurance claims data will serve as a control group reflecting usual care. The intervention will be implemented in 25 hospital departments and 115 general practices in 9 districts in Baden-Wurttemberg. Eligibility criteria for patients are: age > 18 years, hospital admission or hospitalisation, insurance at the sickness fund “AOK Baden-Wurttemberg”, enrolment in general practice-centred care contract. Each study arm will receive different intervention components based on the point of study enrolment and the patient’s medical need. The interventions comprise a) a structured assessment in the general practice prior to admission resulting in an admission letter b) a discharge conversation by phone between hospital and general practice, c) a structured assessment and care plan post-discharge and d) telephone monitoring for patients with a high risk of rehospitalisation. The assessments are supported by a software tool (“CareCockpit”), originally developed for structured case management programmes. The primary outcome (rehospitalisation due to the same indication within 90 days) and a range of secondary outcomes (rehospitalisation due to the same indication within 30 days; hospitalisations due to ambulatory care-sensitive conditions; delayed prescription of medication and medical products/ devices and referral to other health practitioner/s after discharge; utilisation of emergency or rescue services within 3 months; average care cost per year and patient participating in the VESPEERA programme) and quality indicators will be determined based on insurance claims data and CareCockpit data. Additionally, a patient survey on satisfaction with cross-sectoral care and health related quality of life will be conducted.    Discussion: Based on the results, area-wide implementation in usual care is well sought. This study will contribute to an improvement of cross-sectoral care during the admission and discharge process.    Trial registration:  DRKS00014294  on DRKS / Universal Trial Number (UTN): U1111–1210-9657, Date of registration 12/06/2018.
publisher: BioMed Central
date: 2019
type: Article
type: info:eu-repo/semantics/article
type: NonPeerReviewed
format: application/pdf
identifier: https://archiv.ub.uni-heidelberg.de/volltextserverhttps://archiv.ub.uni-heidelberg.de/volltextserver/26244/1/12913_2019_Article_4022.pdf
identifier: DOI:
identifier: urn:nbn:de:bsz:16-heidok-262444
identifier:   Forstner, Johanna ; Straßner, Cornelia ; Kunz, Aline ; Uhlmann, Lorenz ; Freund, Tobias ; Peters-Klimm, Frank ; Wensing, Michel ; Kümmel, Stephanie ; El-Kurd, Nadja ; Rück, Ronja ; Handlos, Bärbel ; Szecsenyi, Joachim  (2019) Improving continuity of patient care across sectors: study protocol of a quasi-experimental multi-centre study regarding an admission and discharge model in Germany (VESPEERA).  BMC Health Services Research, 19 (206).  pp. 1-10.  ISSN 1472-6963     
relation: https://archiv.ub.uni-heidelberg.de/volltextserver/26244/
rights: info:eu-repo/semantics/openAccess
rights: Please see front page of the work (Sorry, Dublin Core plugin does not recognise license id)
language: eng