[Central Patients Admission (CPA) unit--connecting inpatient and outpatient care].
BACKGROUND
Due to the novel reimbursement policies, hospitals face substantial conflicts regarding best patient care and optimal utilization of resources. In order to optimize patient treatment, a central patients admission (CPA) unit has been established.


METHODS
All patients electively referred to the hospital were primarily treated by a medical specialist at the CPA unit. According to an appropriateness evaluation protocol established with the medical service of the health insurances of Bavaria ("MDK-Bayern"), patients were treated as inpatients or outpatients. The impact of this novel admission procedure was assessed for a period of 30 months.


RESULTS
Within 30 months following establishment of the CPA unit, 10% of the patients were treated as outpatients, whereas 90% of referred patients were admitted as inpatients. Nonetheless, numbers of inpatients increased by 20.7% after 24 months compared to 12 months following establishment of the CPA unit with a substantial increase of patients referred by external medical specialists. In addition, there were no cases of inappropriate admission.


CONCLUSIONS
The CPA unit is an ideal instrument for treating patients cross-sectorally as well as more effectively and economically advocating reorganization. Establishment of a CPA unit leads to greater satisfaction among patients, referring physicians, and medical staff.
Fleck
Martin
M
Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum, Regensburg, Germany. m.fleck@asklepios.com
Zeuner
Martin
M
Schölmerich
Jürgen
J
D000553:Ambulatory Care / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D003955:Diagnostic Tests, Routine / Q000191:economics / Q000706:statistics & numerical data; D005858:Germany; D006757:Hospital Units / Q000191:economics / Q000458:organization & administration*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D009313:National Health Programs / Q000191:economics; D010343:Patient Admission / Q000191:economics / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011785:Quality Assurance, Health Care / Q000191:economics / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000191:economics / Q000706:statistics & numerical data; D012051:Reimbursement Mechanisms / Q000191:economics; D019564:Unnecessary Procedures / Q000191:economics / Q000706:statistics & numerical data