Hospital Admission and Discharge: Lessons Learned from a Large Programme in Southwest Germany.

Area of Science:

• Healthcare Management
• Patient Care Coordination
• Health Services Research

Background:

• A structured admission, discharge, and follow-up program (VESPEERA) was implemented within a general practitioner (GP)-based care program.
• The program targeted all hospitalized patients within this care model across 7 hospitals and 72 general practices in southwest Germany.

Observation:

• The VESPEERA program incorporated pre-admission, in-hospital, and post-discharge interventions.
• Effectiveness was primarily assessed by 90-day readmission rates, with implementation process explored via staff questionnaires.

Findings:

• No statistically significant reduction in 90-day readmissions was observed, though effect size was comparable to similar interventions.
• Low intervention fidelity was noted, influenced by factors like resource availability, regulatory requirements, and inter-provider networking.

Implications:

• While structured information transfer is logical, its added value in GP-based programs appears modest.
• Enhanced involvement of primary care teams in pre- and post-hospital care is recommended for future initiatives.