Hospital-to-home® Mobility-supported Post-hospital Care Management in Surgery–Preliminary Experiences in a University Hospital

Abstract

Background Cost-cutting measures in healthcare have led to a tendency to shorten the length of hospital stays. In the area of surgery, patient management systems have been established and have proven their utility in hospital admission and bed management programmes that are tailored to demand and resources. Implementing a patient-oriented system of discharge management is not without its problems; frequently, social and medical services9 scope of action within an institution is r6stricted by administrative and external regulations. If timely and high-quality post-hospital home care cannot be guaranteed, this can lead–for patients of all surgical disciplines–to crisis management. Methods We conducted a pilot evaluation of a clinic-specific and mobilitysupported health service for inhospital discharge and post-hospital home-care management in the surgical department of a teaching hospital in collaboration with regional associations of statutory health insurance physicians. The service was based on the idea of a hospital-to-home ® mobile health service, and the project was called MEDmobil. Results Timely discharge from the hospital and guaranteed post-hospital care are possible through this approach, even in difficult cases such as uncomplicated post-surgery wound care. The fragmentation of economically and surgically necessary services and post-operative home care can, at the end of the process chain, be optimized to meet the interests of all parties involved. Conclusion In the clinical setting, the concept of hospital-to-home ® mobile healthcare services is a patient-oriented and logical reply to the demands made by the DRG system. The interests of patients, hospitals, and social insurance providers are represented without any loss of quality. In addition to creating the logistical prerequisites, changes in attitude are necessary. When patients, GPs, and external service providers have given their approval, efficient implementation depends on modern internal hospital structures.