Problems And Chances At The Interface Between Hospital Care And Geriatric Rehabilitation

Available statistical data offer valuable information on recent demographic changes and developments within European healthcare and welfare systems. The demographic evolution is expected to have considerable impact upon various, major aspects of the economic and social life in all European countries. The healthcare system plays an important role especially in the context of ageing societies, such as Germany. This paper focuses on the evolution of the prevention or rehabilitation service sector during the last years in Germany, analyzes the specific characteristics of the elderly patients being cared for in these facilities and underlines important aspects at the interface between (acute) hospital and geriatric rehabilitative care. Networking, integrated care services and models will be of even greater importance in the future demographic setting generating (most probably) increasing numbers and percentages of elderly, multimorbid hospitalized patients. More than this, the cooperation at regional level between acute geriatric hospital departments and geriatric rehabilitation facilities has become a mandatory quality criterion in the Free State of Bavaria. This paper presents and analyzes issues referring to a precise cooperation model (between acute and rehabilitative care) recommended for implementation even by the Free State of Bavaria while emphasizing several examples of good practice that have guaranteed the success of this cooperation model. The analysis of the main causes leading to longer length of stay (and thus "delayed discharges") for the elderly patients transferred to geriatric rehabilitation facilities within the reference model for acute-rehabilitative care provides important information and points at the existing potential for optimization in the acute hospital setting. Vicinity, tight communication and cooperation, early screening, implementation of standard procedures and case management are some of the activities that have contributed considerably to the improvement of the hospital length of stay and transfer management for elderly patients benefiting from (follow-up) inpatient geriatric rehabilitation services. The presented facts are important not only for the German health setting.