title: [Hospital cooperation models. Safeguarding optimized patient care, medical training and resource utilization].
abstract: BACKGROUND
  In the face of continuous medical progress on the one hand and the increasing cost pressure through the diagnosis-related groups (DRG) system with concomitant hospital privatization on the other, pioneering and economical models for modern and competent patient care are required.
  
  
  METHODS
  The cooperation model of the surgical department of the Heidelberg University Hospital is based on patient selection according to the grade of disease complexity and has been successfully developed in Heidelberg since 2005. The long-term results on the basis of actual proceeds are presented.
  
  
  RESULTS
  Cooperation with the Salem Hospital chaired by the director of the University surgical department has been ongoing for 6 years. General visceral surgery cases with low complexity are treated at the secondary cooperation hospitals whereas complex oncological operations of the esophagus, liver, pancreas, rectum or multivisceral resections and transplantations are performed at the University hospital. Optimal utilization of the operative and infrastructural resources of both cooperation partners lead to an improvement in surgical training and proceeds. Likewise, another cooperation with the secondary hospital in Sinsheim, which started 2 years ago, has shown similar positive results. Clinical rotation for surgical residents and attending surgeons guarantee a complete and competent surgical training in the field of general surgery.
  
  
  CONCLUSIONS
  The long-term results indicate that the cooperation model functions to achieve an optimized treatment of patients and an economical win-win situation for all cooperation partners by differential utilization of the available resources in the hospital network.
authors.affiliation: Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Heidelberg.
authors.forename: T
authors.initials: T
authors.lastname: Welsch
authors.forename: M
authors.initials: M
authors.lastname: von Frankenberg
authors.forename: T
authors.initials: T
authors.lastname: Simon
authors.forename: J
authors.initials: J
authors.lastname: Weitz
authors.forename: D
authors.initials: D
authors.lastname: Jüstel
authors.forename: M W
authors.initials: MW
authors.lastname: Büchler
mesh_terms: D002983:Clinical Competence / Q000191:economics; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics*; D004502:Education, Medical, Continuing / Q000191:economics*; D005858:Germany; D019981:Health Care Sector / Q000191:economics; D006302:Health Services Research; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006755:Hospital Shared Services / Q000191:economics*; D006801:Humans; D009313:National Health Programs / Q000191:economics*; D058996:Quality Improvement / Q000191:economics; D012051:Reimbursement Mechanisms / Q000191:economics*; D040841:Resource Allocation / Q000191:economics*