After clinic: transition should be easier

A framework contract is to facilitate the patient the first time after the hospital stay. However, the implementation is difficult

The Federal Council möchte patients Ütransition to outpatient care make it easier. However, the new draft law is controversial

Many patients who leave the hospital are still längst is not entirely healthy. You need hädomestic care, such as after a stroke, benötransparent tablets, physiotherapy, walking AIDS. "Patients should k&uuml after their discharge, but their convalescence;protease inhibitors and non-Anträge in health insurance or medication and tools to organize müssen", Regina Behrendt of the Verbraucherzentrale NRW says.

Therefore, the Federal Council has passed a law that the Ütransition to ambulatory care to facilitate. In October 2017, the zugeh&ouml joined;rige framework contract in force. Now köcan Klinikädoctors prepare the therapy after discharge better. Unlike in the past, düyou may now Arbeitsunfäability to certify drugs für the first seven days, to prescribe, as well Rehamaßtook, home helps or AIDS – so care beds, Rollstüchairs or walking AIDS. However, there are problems in the implementation.

"Zunäfirst of all, the idea behind a structured discharge management absolutely positiv", Cindy Stoklossa, centralized technical management of the social service at the Charit&eacute says; in Berlin. First of all begrüßt, now that multi-professional Teams from different directions of view to assess together with the patient, what this benötransparent. "But the new rules mean a huge bürokratischen, logistical and human Aufwand", bemängelt Stoklossa, which also trains staff from other clinics in this area.

Bürokratischer effort with consequences

Due to the additional tasks stoßen Krankenhäuser häoften to their limits. For example, a new printer needs the für are suitable for the Printing of the recipes. Software and management systems müshoot will be adjusted accordingly. And, ultimately, the discharge management with all its b&uuml means;rokratischen case, a lot of Extra&shy knit and forms;work für Ädoctors, nursing staff and social services – without having to compensate for a more Verfüaside.

"The bottom line is that valuable time is going für the treatment of patients verloren", Dr. Bernd Metzinger, Gesch&auml says;ftsfüleader of the Department für human resources and Krankenhausorga­the organization of the German Krankenhaus­society.

In addition, müKrankenhaus&auml down;doctors plöin addition to the same game rules as established Ädoctors – so, about know what you are in front of the Background of the cost-effectiveness üin General, prescribe dümay. "This is für the Klinikädoctors like Learning a Fremdsprache", Dr. Kai Behrens, spokesman for the AOK Federal Association says.

In practice, käme, therefore, to errors. Wrong ausgefüfilled Anträge and forms müshot once again zurübe ckgeschickt – or the patient with an incorrectly issued a prescription at the pharmacy, and the pharmacist must aush&auml your medication is not;complete. "As I completed my specialist training was a half a year of preparation, on the Tätransparency as a doctor provided – today Krankenhaus&auml to;the time doctors just by the way machen", also criticizes Metzinger.

An impression of immature projects

He wüonly staff f&uuml not want to get up;r the clinics, so the more work üin General to bewäis valid, but, above all, clearer Abläufe and rules. "In many Fäcases, is not yet clearly geklärt, what is the cost of the regulations of the health insurance übe accepted and what nicht", Metzinger says. The Verun­fuse on the side of the Klinikädoctors is high.

"In the result they prescribe rather zögerlich – out of a fear that the sickness Fund, the prescribed drugs or remedies womöpossible not übernimmt", criticized Verbraucherschützerin Behrendt. The Möopportunities of the new law, the patient unterstüetching, wü&shy authorities, therefore,;currently not fully ausgeschöpft.

Other aspects of the new rules are not optimal für the ­­patients and hinder a smooth Ütransition into outpatient care. So dümay be issued to the recipes and regulations only on the day of discharge. "A care bed or a home help müshot but then to Verfüare available and köcan be organized only on the day of discharge, if the Patient is already on the way home befindet", erläservice Stoklossa explained Social.

Profitable Supply Connection

Added: Häfrequently, regulation, or reimbursement of costs are not the Problem, but the lack of resources. Stoklossa: "A recipe für a home help or physiotherapy does not help much, if no one to Verfüaside, this task in a timely manner üaccept can."

It was up to Stoklossa, would the framework contract for the discharge management of a grüsensitive Üprocessing. Among other things, she hopes for a better adaptation to the Realität in the hospital everyday. For example, ausschlie&szlig to;lich Ädoctors the relief prescriptions – exactly on the day of the dismissal. "The Ädoctors are in the clinic everyday, not always on the Station of the hand, but also changes in the OP", so Stoklossa. Supposedly, the head Association of health insurance funds is currently preparing a Üprocessing of the discharge management.

Verbraucherschützerin Behrendt rät all hospital patients now, the consent for discharge management to write and edit afterwards. "Because, even if currently not all rundläuft – You will benefit in accordance with the hospital stay in each case of a seamless connection of supply."

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