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This article is part of the supplement: International Conference on Prevention & Infection Control (ICPIC 2011)

Open Access Poster presentation

A new case management concept to decrease the rehospitalisation rate in heurischemic

G Rümenapf1, S Geiger2, A Godel3, W Vogelsang4, S Morbach5, N Wilhelm6 and N Nagel7*

  • * Corresponding author: N Nagel

Author Affiliations

1 Clinic for Vascular Surgery, Diakonissen-Stiftungs-Krankenhaus Speyer , Speyer, Germany

2 Case Management, Diakonissen-Stiftungs-Krankenhaus Speyer , Speyer, Germany

3 Medical Controlling, Diakonissen-Stiftungs-Krankenhaus Speyer , Speyer, Germany

4 CEO, Diakonissen-Stiftungs-Krankenhaus Speyer , Speyer, Germany

5 Dept. Of Diabetology and Angiology, Marienkrankenhaus Soest, Soest, Germany

6 Konzeptmanagement, B. Braun Melsungen AG, Melsungen, Germany

7 Medical Scientific Affairs OPM, B. Braun Melsungen AG, Melsungen, Germany

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BMC Proceedings 2011, 5(Suppl 6):P326  doi:10.1186/1753-6561-5-S6-P326


The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1753-6561/5/S6/P326


Published:29 June 2011

© 2011 Rümenapf et al; licensee BioMed Central Ltd.

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Introduction / objectives

The treatment of patients suffering from the neuroischemic diabetic foot syndrome (DFS) comprises arterial revascularization (e.g. below-knee bypass surgery), minor amputations, debridements, as well as long-term specialized wound care. Following premature discharge to the homecare sector, the quality of postoperative care is often inadequate. Many patients are readmitted. We studied the influence of a trans-sectoral case management (CM), ensuring outpatient care according to our clinical standards, on the readmission rate, length of hospital stay (LOS) and the hospital's costs/benefit situation.

Methods

DFS patients after implementation of the CM (Case Management Group (CMG); n = 202; 2007-2008) were compared with a historic control group (HCG; n = 190; 2005-2006). All patients had high maintenance foot wounds as well as healing incisional wounds following bypass surgery. Both groups were matched for the principal diagnosis, a patients clinical complexity level (PCCL) of 4, and G-DRG-related flat rate. From the 202 CMG patients evaluated, 54 received long-term trans-sectoral care by the CM.

Results

The rehospitalization rate in the CMG was significantly reduced versus the HCG (9,8 % vs.16,7%; p = 0,041). The reduction of the revolving door effect in the CMG significantly improved the costs/revenue situation for the hospital. The LOS was unchanged.

Conclusion

The implementation of a hospital-based trans-sectoral CM significantly reduces the rehospitalization rate in patients with neuroischemic DFS requiring bypass surgery. Hospital economics are improved.

Disclosure of interest

None declared.