Can german discharge management by law support people with cognitive impairments across sectors
Fanny Schumacher‐Schönert, Melanie Boekholt, Angela Nikelski, Friederike Kracht, Horst Christian Vollmar, Wolfgang Hoffmann, Stefan Kreisel, Jochen René Thyrian- Psychiatry and Mental health
- Cellular and Molecular Neuroscience
- Geriatrics and Gerontology
- Neurology (clinical)
- Developmental Neuroscience
- Health Policy
- Epidemiology
Abstract
Around 1.8 million people in Germany live with dementia. Ascending trend. Discharging people with cognitive impairment from the hospital and transitioning them to outpatient care brings special challenges and presents the health care system with a new and increasingly important task. In Germany there are legal efforts (§39 paragraph 1a, SGB V) to close gaps, wich are supposed to develop the discharge and transfer process. A relevant Cochrane review provided further impressions of the effectiveness of individualized discharge planning.
The analysis is part of the intersec‐CM study; a multi‐centered, randomized controlled study to analyze the effectiveness of an intersectoral intervention and care management system. Discharge documents of all documents available at the time of discharge could be recorded by n = 382 subjects. This corresponds to a sample size of 95.02% of the total study population.
Aim of the presentation is to provide an overview of the documentation process for discharge and transfer management in everyday clinical practice after the discharge management law came into force in accordance with §39 paragraph 1a, SGB V. It answers the research question „What form does documentation take within the framework of statutory discharge management for people with cognitive impairments?“ It highlights further characteristics of the discharge documents for vulnerable patient groups and shows which contents in the discharge documentation play a role in order to be able to provide cross‐sectoral support for people with cognitive impairment.
There can be shown three findings; formal, content‐related and translational results. Even formal results show, that there is no standardization for discharge documents. Further content‐related results confirm, that the documentation process according to §39 paragraph 1a, SGB V has large documentation gaps. The documentation appears to be heterogeneous and communication for follow‐up treatment needs improvement. The greatest learning objective is to create awareness for standardization in the discharge documentation for people with cognitive impairment.