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[Interface Problems Between Inpatient, GP and Outpatient Specialist Care: Viewpoint of General Practitioners in
Caroline Lang1, Mandy Gottschall1, Maik Sauer1
1Medizinische Klinik III, Bereich Allgemeinmedizin, Universitätsklinikum "Carl Gustav Carus" der Technischen Universität Dresden, Dresden.
Objectives:
The aim of the study was to identify interface problems between inpatient, GP and outpatient specialist care from the perspective of general practitioners in Dresden, especially in older multimorbid patients.
Methods:
The data were collected in the context of the pilot study "Multimedication and its Consequences for the Primary Care of Patients in Saxony" and included guided interviews with 7 general practitioners. The interviews were transcribed and analyzed according to the inductive content analysis of Mayring.
Results:
At the interface of inpatient to outpatient care, several problems regarding discharge management, intersectoral communication and cooperation as well as in the management of medication were found. Concerning the interface between general practitioners and outpatient specialist care, problems were particularly marked with regard to free choice of doctors, appointment management, medical decision-making process, medication management as well as the use of the electronic health card. Regardless of the interfaces, the lack of communication could be worked out as a central challenge.
Conclusion:
There are several problems with all adjacent interfaces. What is striking here is the lack of communication and cooperation between all parties involved. Possible causes were the often very different working methods and framework conditions, human and material resources and therapeutic intentions and approaches between the different interfaces. One possible approach to improve the situation may be the law regarding secure digital communications and healthcare applications, which exists since 2016. Among other things, it promises a secure and rapid inter- and intrasectoral exchange of patient data. The overall goal of healthcare in Germany should be an optimized and process-oriented interface management in order to ensure a secure and seamless sectoral transition to patients.
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