Improving continuity of patient care across sectors: Introducing the VESPEERA admission and discharge model in Germany

• Register: German Clinical Trials Register
• Last refreshed on: 8 April 2024
• Main ID: DRKS00014294
• Date of registration: 12/06/2018
• Prospective Registration: Yes
• Primary sponsor: Universitätsklinikum HeidelbergAbteilung Allgemeinmedizin und Versorgungsforschung
• Public title: Improving continuity of patient care across sectors: Introducing the VESPEERA admission and discharge model in Germany
• Scientific title: Improving continuity of patient care across sectors: Introducing the VESPEERA admission and discharge model in Germany - VESPEERA
• Date of first enrolment: 15/06/2018
• Target sample size: 7088
• Recruitment status: Complete
• URL: http://drks.de/search/en/trial/DRKS00014294
• Study type: interventional
• Study design: Allocation: Non-randomized controlled study; Masking: Open (masking not used); Control: No treatment / Standard of care; Assignment: factorial; Study design purpose: health services research
• Phase: N/A

Countries of recruitment

Germany

Contacts

• Name: Johanna Forstner
• Affiliation: Universitätsklinikum HeidelbergAbteilung Allgemeinmedizin und Versorgungsforschung

• Name: Johanna Forstner
• Affiliation: Universitätsklinikum HeidelbergAbteilung Allgemeinmedizin und Versorgungsforschung

Key inclusion & exclusion criteria

Inclusion criteria: All patients aged 18 years and older and who are able to give their consent, who are insured with the sickness fund AOK Baden-Württemberg, who participate in GP-based care according to § 73b Social Code Book V and who are being admitted into or released from a hospital are eligible for study participation.
Exclusion criteria: Patients residing in long-term care facilities are excluded from study participation because of organizational reasons since their care processes are influenced by different factors.

Age minimum: 18 Years
Age maximum: None
Gender: All

Health Condition(s) or Problem(s) studied

Processes of admission and discharge management for patients before and after hospital stays

Intervention(s)

Group 1: Intervention group. The delivery of the intervention is influenced by different factors: on the one hand, it is important whether the hospital admission of the patient was planned or not. On the other hand, the belonging to a study arm depends on the fact, if the hospital department in which the patient is being treated takes part in the VESPEERA program according to § 140a Social Code Book V.
The following intervention components will be applicable:
a) Interventions in the GP-practice before hospital admission:
Prior to a hospital stay the Care Assistant in General Practice (VERAH) will check the patients’ health status using a certain assessment. On the basis of this data an admission letter will be generated in order to support the treating hospital staff in terms of treatment and discharge planning. The admission letter will consist of information regarding the patients’ disease pattern as well as his/her domestic situation prior to the hospital stay.
b) Interventions during the hospital stay:
If the patient is being treated in a hospital department that takes part in the study, the following study interventions will be conducted. If the treating hospital physician or other persons involved into the patients’ care process think it is necessary, a telephone conversation between hospital and general care practice will take place. Within this conversation the general care practice will be informed about the patients’ treatment and discharge date before the discharge actually took place. Furthermore, the patient will be informed about the following steps after hospital discharge within a discharge conversation and supported by a special information broschure.
c) Interventions in the general practice after discharge:
After the hospital stay the patient will

Primary Outcome(s)

Number of rehospitalizations due to the same indication within a time frame of three months to the outpatient sector

Secondary Outcome(s)

1. number of rehospitalizations due to the same indication within a time frame of 30 days (case consolidation) (Fallzusammenlegung)
2. number of hospitalizations due to ambulatory care-sensitive diagnoses
3. number of patients with discharge to the outpatient sector from a participating hospital where the continued prescription of medication is delayed
4. number of patients with discharge to the outpatient sector from a participating hospital where the continued prescription of non-medical remedies (Heilmittel) is delayed
5. number of patients with discharge to the outpatient sector from a participating hospital where the continued prescription of devices (Hilfsmittel) is delayed
6. number of patients after hospital discharge from a participating hospital who use emergency or rescue services within a time frame of three months
7. average care cost per year and HzV-insured person who is registered for the new care form
8. patient-reported experiences and health-related outcome of cross-sectoral care using the German version of the instrument Patients’ Experiences Across Health Care Sectors (PEACS)
9. health-related quality of life, using the instrument EuroQol (EQ-5D)

Secondary ID(s)

U1111-1210-9657

Source(s) of Monetary Support

Innovationsausschuss beim Gemeinsamen Bundesausschuss- Innovationsfonds -

Ethics review

Status: Approved
Approval date: 02/03/2018
Contact:

[e-mail]

Ethikkommission der Medizinischen Fakultät Heidelberg

[phone]

[e-mail]

Results

• Date Completed: 30/09/2019
• URL: http://drks.de/search/en/trial/DRKS00014294#studyResults