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)
Abstract 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...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-03-01
|
| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-019-4022-4 |
| _version_ | 1828499368069562368 |
|---|---|
| author | Johanna Forstner Cornelia Straßner Aline Kunz Lorenz Uhlmann Tobias Freund Frank Peters-Klimm Michel Wensing Stephanie Kümmel Nadja El-Kurd Ronja Rück Bärbel Handlos Joachim Szecsenyi |
| author_facet | Johanna Forstner Cornelia Straßner Aline Kunz Lorenz Uhlmann Tobias Freund Frank Peters-Klimm Michel Wensing Stephanie Kümmel Nadja El-Kurd Ronja Rück Bärbel Handlos Joachim Szecsenyi |
| author_sort | Johanna Forstner |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-11T13:23:26Z |
| format | Article |
| id | doaj.art-93dbd1f54eac4a978ef34ac968794013 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-11T13:23:26Z |
| publishDate | 2019-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-93dbd1f54eac4a978ef34ac9687940132022-12-22T01:05:40ZengBMCBMC Health Services Research1472-69632019-03-0119111010.1186/s12913-019-4022-4Improving continuity of patient care across sectors: study protocol of a quasi-experimental multi-centre study regarding an admission and discharge model in Germany (VESPEERA)Johanna Forstner0Cornelia Straßner1Aline Kunz2Lorenz Uhlmann3Tobias Freund4Frank Peters-Klimm5Michel Wensing6Stephanie Kümmel7Nadja El-Kurd8Ronja Rück9Bärbel Handlos10Joachim Szecsenyi11Department for General Practice and Health Services Research, University Hospital HeidelbergDepartment for General Practice and Health Services Research, University Hospital HeidelbergDepartment for General Practice and Health Services Research, University Hospital HeidelbergDepartment for Medical Biometry, University Hospital of Heidelberg, Institute for Medical Biometry and InformaticsDepartment for General Practice and Health Services Research, University Hospital HeidelbergDepartment for General Practice and Health Services Research, University Hospital HeidelbergDepartment for General Practice and Health Services Research, University Hospital HeidelbergaQua -Institute GmbHAOK Baden-WürttembergHÄVG Hausärztliche Vertragsgemeinschaft Aktiengesellschaft Regionaldirektion SüdGesundheitstreffpunkt MannheimDepartment for General Practice and Health Services Research, University Hospital HeidelbergAbstract 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.http://link.springer.com/article/10.1186/s12913-019-4022-4Patient admissionPatient dischargeCross-sectoral careContinuity of patient carePatient readmissionCommunication |
| spellingShingle | Johanna Forstner Cornelia Straßner Aline Kunz Lorenz Uhlmann Tobias Freund Frank Peters-Klimm Michel Wensing Stephanie Kümmel Nadja El-Kurd Ronja Rück Bärbel Handlos Joachim Szecsenyi 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 Patient admission Patient discharge Cross-sectoral care Continuity of patient care Patient readmission Communication |
| 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) |
| title_full | 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) |
| title_fullStr | 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) |
| title_full_unstemmed | 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) |
| title_short | 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) |
| title_sort | 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 |
| topic | Patient admission Patient discharge Cross-sectoral care Continuity of patient care Patient readmission Communication |
| url | http://link.springer.com/article/10.1186/s12913-019-4022-4 |
| work_keys_str_mv | AT johannaforstner improvingcontinuityofpatientcareacrosssectorsstudyprotocolofaquasiexperimentalmulticentrestudyregardinganadmissionanddischargemodelingermanyvespeera AT corneliastraßner improvingcontinuityofpatientcareacrosssectorsstudyprotocolofaquasiexperimentalmulticentrestudyregardinganadmissionanddischargemodelingermanyvespeera AT alinekunz improvingcontinuityofpatientcareacrosssectorsstudyprotocolofaquasiexperimentalmulticentrestudyregardinganadmissionanddischargemodelingermanyvespeera AT lorenzuhlmann improvingcontinuityofpatientcareacrosssectorsstudyprotocolofaquasiexperimentalmulticentrestudyregardinganadmissionanddischargemodelingermanyvespeera AT tobiasfreund improvingcontinuityofpatientcareacrosssectorsstudyprotocolofaquasiexperimentalmulticentrestudyregardinganadmissionanddischargemodelingermanyvespeera AT frankpetersklimm improvingcontinuityofpatientcareacrosssectorsstudyprotocolofaquasiexperimentalmulticentrestudyregardinganadmissionanddischargemodelingermanyvespeera AT michelwensing improvingcontinuityofpatientcareacrosssectorsstudyprotocolofaquasiexperimentalmulticentrestudyregardinganadmissionanddischargemodelingermanyvespeera AT stephaniekummel improvingcontinuityofpatientcareacrosssectorsstudyprotocolofaquasiexperimentalmulticentrestudyregardinganadmissionanddischargemodelingermanyvespeera AT nadjaelkurd improvingcontinuityofpatientcareacrosssectorsstudyprotocolofaquasiexperimentalmulticentrestudyregardinganadmissionanddischargemodelingermanyvespeera AT ronjaruck improvingcontinuityofpatientcareacrosssectorsstudyprotocolofaquasiexperimentalmulticentrestudyregardinganadmissionanddischargemodelingermanyvespeera AT barbelhandlos improvingcontinuityofpatientcareacrosssectorsstudyprotocolofaquasiexperimentalmulticentrestudyregardinganadmissionanddischargemodelingermanyvespeera AT joachimszecsenyi improvingcontinuityofpatientcareacrosssectorsstudyprotocolofaquasiexperimentalmulticentrestudyregardinganadmissionanddischargemodelingermanyvespeera |