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The Contribution of Intersectoral Healthcare Centres with an Extended Outpatient Care Model to Improve Regional Care-Structures—A Qualitative Study

Author

Listed:
  • Heidrun Sturm

    (Institute of General Practice and Interprofessional Care, University Hospital Tübingen, 72076 Tübingen, Germany)

  • Florian Kaiser

    (Oberender AG, Wahnfriedstraße 3, 95440 Bayreuth, Germany)

  • Philipp Leibinger

    (Oberender AG, Wahnfriedstraße 3, 95440 Bayreuth, Germany)

  • Edgar Drechsel-Grau

    (Institute of General Practice and Interprofessional Care, University Hospital Tübingen, 72076 Tübingen, Germany)

  • Stefanie Joos

    (Institute of General Practice and Interprofessional Care, University Hospital Tübingen, 72076 Tübingen, Germany)

  • Andreas Schmid

    (Oberender AG, Wahnfriedstraße 3, 95440 Bayreuth, Germany
    Management im Gesundheitswesen, Rechts-und Wirtschaftswissenschaftliche Fakultät, Universität Bayreuth, Universitätsstraße 30, 95447 Bayreuth, Germany)

Abstract

Many smaller hospitals in Germany are currently threatened with closure due to economic reasons and politically derived centralization. In some—especially rural areas—this may result in a lack of accessible local care structures. At the same time, patients are unnecessarily admitted to hospitals due to insufficient primary care structures and healthcare coordination. Intersectoral health centers (IHC), as new intermediary structures, may offer round-the-clock monitoring (Extended Outpatient Care, EOC), with fewer infrastructure needs than hospitals and, thus, could offer a sustainable solution. In an iterative process, 30 expert interviews (with physicians, nurses and other healthcare experts) formed the basis for the derivation of diagnostic groups, relevant related patient characteristics and scenarios, as well as structural preconditions necessary for safe care in the setting of the new model of IHC/EOC. Additionally, three workshops within the multidisciplinary research team (including healthcare services researchers, GPs, and health economists) were performed. Inductive categories on disease-, case-, sociodemographic- and infrastructure-related criteria were derived following thematic analysis. Due to the expert interviews, general practice equipment plus continuous monitoring beds should form the basic infrastructure for EOCs, which should be adjusted to local needs and infrastructure demands. GPs could be aided through (electronic) support by other specialists. IHC, as a physician-led facility, should rely on experienced nurses to allow for 24-h services and to support integrated team-based primary care with GPs. Alongside nurses, case managers, therapists and social workers can be included in the structure, allowing for improved integration of (primary) care services. In order to sustain low-threshold, local access to care, especially in rural areas, IHC with extended monitoring and integration of coordinative support, emerged as a promising solution that could solve many common patient needs without the need for hospital-based inpatient care.

Suggested Citation

  • Heidrun Sturm & Florian Kaiser & Philipp Leibinger & Edgar Drechsel-Grau & Stefanie Joos & Andreas Schmid, 2023. "The Contribution of Intersectoral Healthcare Centres with an Extended Outpatient Care Model to Improve Regional Care-Structures—A Qualitative Study," IJERPH, MDPI, vol. 20(7), pages 1-11, April.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:7:p:5365-:d:1114491
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    References listed on IDEAS

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    1. Schuettig, Wiebke & Sundmacher, Leonie, 2019. "Ambulatory care-sensitive emergency department cases: a mixed methods approach to systemize and analyze cases in Germany," Munich Reprints in Economics 78210, University of Munich, Department of Economics.
    2. Sundmacher, Leonie & Fischbach, Diana & Schuettig, Wiebke & Naumann, Christoph & Augustin, Uta & Faisst, Cristina, 2015. "Which hospitalisations are ambulatory care-sensitive, to what degree, and how could the rates be reduced? Results of a group consensus study in Germany," Health Policy, Elsevier, vol. 119(11), pages 1415-1423.
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