Hospital-to-home®-mobility supported postoperative care management for surgical wards

Abstract

Background To reduce costs in the inpatient sector, hospitals are tending towards reducing the duration of hospitalisation. With respect to demand- and resource-based inpatient admissions and bed-occupancy planning, patient management systems have proven their value and are established on surgical wards. Nevertheless, as the final link in the process chain, patient-centred inpatient discharge procedures are not without problems. In many cases, in the absence of provision for competent aftercare in the patient's home, the situation becomes a crisis-management scenario, particularly for post-operative surgery patients. Methods Solutions to this area of potential conflict have been developed by hospital-to-home ® mobile health services. These prototypical solutions were monitored and evaluated during clinical application at a university hospital in cooperation with and with the agreement of the regional association of doctors serving patients with statutory health insurance, in this instance under the designation Medmobil. Results The concept developed by hospital-to-home ® mobile health services enables inpatient discharge even for complicated cases where potential risk exists (e.g. with wound-healing disorders). Data Patient recruitment n =201/6month observation period, 87% visceral- and transplantation surgery. Wound status and discharge points, 37% primary and 63% secondary wound-healing disorders. Motivation to access Medmobil service; 96% return to usual surroundings at home, 84% avoidance of unnecessary waiting time, 83% confidence in the hospital service personal and 27% personal obligations. Assessment of quality of life (SF-36). In summary, highly significant improvement in the general status (physically >mentally, p ® mobile health services is primarily a patient-focused, logical outcome of the requirements of the DRG (diagnosis-related groups) system. Conclusion The interests of the patients, the hospital owners and the insurance companies are represented. Given the positive response from patients, no obstacles exist – contrary to initial expectations – at the general practitioner level and in terms of external care services; rather, they exist primarily with respect to hospital care structures.