TY  - JOUR
ID  - heidok26244
VL  - 19
PB  - BioMed Central
AV  - public
IS  - 206
UR  - https://archiv.ub.uni-heidelberg.de/volltextserver/26244/
JF  - BMC Health Services Research
N2  - 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.
CY  - London
EP  - 10
A1  - Forstner, Johanna
A1  - Straßner, Cornelia
A1  - Kunz, Aline
A1  - Uhlmann, Lorenz
A1  - Freund, Tobias
A1  - Peters-Klimm, Frank
A1  - Wensing, Michel
A1  - Kümmel, Stephanie
A1  - El-Kurd, Nadja
A1  - Rück, Ronja
A1  - Handlos, Bärbel
A1  - Szecsenyi, Joachim
SP  - 1
Y1  - 2019///
TI  - 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)
KW  - Patient admission
KW  -  Patient discharge
KW  -  Cross-sectoral care
KW  -  Continuity of patient care
KW  -  Patient readmission
KW  -  Communication
KW  -  Interprofessional coordination
KW  -  Patient-centered care
KW  -  Health services research
KW  -  Implementation science
SN  - 1472-6963
ER  -