Cross-sectoral patient care in the district of Hamburg Harburg: an example of urological cooperation

Abstract

Ensuring future urological care at the interface between out- and inpatient care is challenging due to demographic developments with an increasing proportion of urological diseases, the simultaneous threat of ashortage of physicians, and the increasing outpatient treatment of complex urological diseases. The cross-sectoral cooperation model between auniversity maximum care provider and the urologic joint practice with ahospital affiliation (BAG) presented below can serve as an ideal model for outpatient-inpatient care. Since 2016, there has been close cooperation between the BAG in Winsen/Buchholz and the University Medical Center Hamburg-Eppendorf (UKE). In addition to direct patient transfer and the continuous pre- and posttreatment of patients, two residents from the UKE rotate to the BAG every year. The BAG benefits from this cooperation through planning security and support in everyday patient care, while the UKE benefits from patient transfer as well as surgical and "basic urological" training of residents. By avoiding duplicate examinations and earlier discharge of patients into outpatient follow-up care, resources are spared. Meaningful patient preselection enables minor interventions to be performed close to home via the BAG, whereas complex cases are carried out at acenter of excellence. The cooperation is seen positively by all parties without exception and, above all, as abenefit for the patient's wellbeing. The optimal training and further education of young urologists in this expanding field can thus be supported and should be integrated into urological resident training.