Abstract

BackgroundIn Germany, a decreasing number of general practitioners (GPs) face a growing number of patients with multimorbidity. Whilst care for patients with multimorbidity involves various healthcare providers, the coordination of this care is one of the many responsibilities of GPs. The aims of this study are to identify the barriers to the successful coordination of multimorbid patient care and these patients’ complex needs, and to explore the support needed by GPs in the care of multimorbid patients. Interviewees were asked for their opinion on concepts which involve the support by additional employees within the practice or, alternatively, external health care professionals, providing patient navigation.MethodsThirty-two semi-structured, qualitative interviews were conducted with 16 GPs and 16 medical practice assistants (MPAs) from 16 different practices in Berlin. A MPA is a qualified non-physician practice employee. He or she undergoes a three years vocational training which qualifies him or her to provide administrative and clinical support.The interviews were digitally recorded, transcribed and analysed using the framework analysis methodology.ResultsThe results of this paper predominantly focus on GPs’ perspectives of coordination within and external to general practice. Coordination in the context of care for multimorbid patients consists of a wide range of different tasks. Organisational and administrative obstacles under the regulatory framework of the German healthcare system, and insufficient communication with other healthcare providers constitute barriers described by the interviewed GPs and MPAs. In order to ensure optimal care for patients with multimorbidity, GPs may have to delegate responsibilities associated with coordinating tasks. GPs consider the deployment of an additional specifically qualified employee inside the general practice to take on coordinative and social and legal duties to be a viable option.ConclusionsThe cross-sectoral cooperation between all involved key players working within the healthcare system, as well as the coordination of the whole care process, is seemingly challenging for GPs within the complex care system of multimorbid patients. GPs are generally open to the assignment of a person to support them in coordination tasks, preferably situated within the practice team.

Highlights

  • In Germany, a decreasing number of general practitioners (GPs) face a growing number of patients with multimorbidity

  • In this paper we report the results of the interviews with the GPs, complemented by the views of the interviewed Medical practice assistant (MPA)

  • This paper explores the perspective of GPs, complemented by the views of MPAs of the same practices, of requirements and barriers for the coordination of care of patients with complex needs, such as multimorbid patients

Read more

Summary

Introduction

In Germany, a decreasing number of general practitioners (GPs) face a growing number of patients with multimorbidity. Interviewees were asked for their opinion on concepts which involve the support by additional employees within the practice or, alternatively, external health care professionals, providing patient navigation. Due to a recent demographic change in Germany, GPs are faced with a growing number of patients with multimorbidity. The care of these patients with complex needs is often provided by multiple doctors and a range of other healthcare professionals, and the coordination of their care is challenging for both GPs and patients [1]. Coordination of care for multimorbid patients means a functioning trans-sectoral care that interlocks all involved healthcare providers. Research findings suggest that coordination of care in general practice as well as care provided by multidisciplinary teams can enhance the continuity of care of patient with multimorbidity [2,3,4]

Objectives
Methods
Results
Discussion
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call