Integrative hospital treatment in older patients to benchmark and improve outcome and length of stay – the In-HospiTOOL study

BMC Health Services Research

Sabina de Geest¹  Fahim Ebrahimi²  Stefano Bassetti²  Jens Eckstein²  Juerg Beer³  Michael Egloff³  Claus Hoess⁴  Vladimir Kaplan⁵  Heinz Schaad⁶  Tobias Ehmann⁷  Zeljka Caldara⁸  Daniel Koch⁸  Ciril Baechli⁸  Beat Mueller⁸  Antoinette Conca⁸  Sebastian Haubitz⁸  Katharina Regez⁸  Ursula Schild⁸  Alexander Kutz⁸  Philipp Schuetz⁸  Ulrich Wagner⁹ 

[1] Department of Public Health of the Faculty of Medicine, University Hospital Basel;Division of Internal Medicine, University Hospital Basel;Internal Medicine Department, Kantonsspital Baden;Internal Medicine Department, Kantonsspital Muensterlingen;Internal Medicine Department, Kreisspital Muri;Internal Medicine Department, Spital Interlaken, FMI;Internal Medicine Department, Spital Zofingen;Medical University Department, Division of General Internal and Emergency Medicine, Kantonsspital Aarau;Swiss Federal Office for Statistics;

关键词: Health services research;    Integrated care;    Interprofessional;    Polymorbidity;    Transition;    Discharge planning;   

DOI  :  10.1186/s12913-019-4045-x

来源: DOAJ

【 摘 要 】

Abstract Background A comprehensive in-hospital patient management with reasonable and economic resource allocation is arguably the major challenge of health-care systems worldwide, especially in elderly, frail, and polymorbid patients. The need for patient management tools to improve the transition process and allocation of health care resources in routine clinical care particularly for the inpatient setting is obvious. To address these issues, a large prospective trial is warranted. Methods The “Integrative Hospital Treatment in Older patients to benchmark and improve Outcome and Length of stay” (In-HospiTOOL) study is an investigator-initiated, multicenter effectiveness trial to compare the effects of a novel in-hospital management tool on length of hospital stay, readmission rate, quality of care, and other clinical outcomes using a time-series model. The study aims to include approximately 35`000 polymorbid medical patients over an 18-month period, divided in an observation, implementation, and intervention phase. Detailed data on treatment and outcome of polymorbid medical patients during the in-hospital stay and after 30 days will be gathered to investigate differences in resource use, inter-professional collaborations and to establish representative benchmarking data to promote measurement and display of quality of care data across seven Swiss hospitals. The trial will inform whether the “In-HospiTOOL” optimizes inter-professional collaboration and thereby reduces length of hospital stay without harming subjective and objective patient-oriented outcome markers. Discussion Many of the current quality-mirroring tools do not reflect the real need and use of resources, especially in polymorbid and elderly patients. In addition, a validated tool for optimization of patient transition and discharge processes is still missing. The proposed multicenter effectiveness trial has potential to improve interprofessional collaboration and optimizes resource allocation from hospital admission to discharge. The results will enable inter-hospital comparison of transition processes and accomplish a benchmarking for inpatient care quality.

【 授权许可】

Unknown