[The ambulatory-stationary interface in medical health care: problems, model of explanation, and possible solutions].
Due to the strict separation between ambulatory and hospital care in Germany, there are problems in terms of communication between the different health-care sectors which can lead to discontinuity in care or to treatment errors. There are only very few studies in Germany so far dealing with the ambulatory-stationary interface from the clinicians' point of view. The quality of collaboration at the interface between ambulatory and hospital care is judged to be deficient by hospital physicians. Deficits in terms of communication and organization are common reasons for this problem which is also demonstrated in other foreign studies. Against the background of the model of interaction in the ambulatory-stationary interface, several solutions for a better communication between physicians in ambulatory and stationary sector are discussed: gate keeper model, standardized patient hospitalization report, electronic health cards or other strategies like the Danish model (general practioners as advisors and coordinators in hospitals) or transsectoral quality circles.
Ommen
Oliver
O
ZVFK - Zentrum für Versorgungsforschung Köln, Medizinische Fakultät, Universität zu Köln, Köln, Germany. oliver.ommen@uk-koeln.de
Ullrich
Britta
B
Janssen
Christian
C
Pfaff
Holger
H
D000553:Ambulatory Care; D003142:Communication; D003299:Cooperative Behavior; D003718:Denmark; D004282:Documentation / Q000592:standards; D005194:Family Practice; D005858:Germany; D006302:Health Services Research; D006760:Hospitalization; D006801:Humans; D016347:Medical Records Systems, Computerized; D009313:National Health Programs; D010348:Patient Care Team; D012017:Referral and Consultation