The entirety of emergency department patients is included. No specific diseases are examined.
Conditions
Interventions
Group 1: Separate outpatient care model within the emergency department premises or on the hospital grounds
Group 2: Emergency service practice of the Regional Association of Statutory Health Insuranc
Sponsors
Notfallmedizinische Versorgungsforschung (CVK, CCM), Charité - Universitätsmedizin Berlin
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Self-presentation at the emergency department
Exclusion criteria
Exclusion criteria: Insufficient cognitive status to understand the information about the study content and to consent to the study; insufficient proficiency in German or English for the interview; patients who require immediate medical care (e.g., unstable, intubated patients); patients with no legal representative present; minors; non-self-referred presentation in the emergency department; purposeful presentation in the alternative outpatient care model
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The Primary outcome is the actual and expected efficiency of the care models: Proportion of patients who actually received care in an alternative care model or who could have received medically appropriate care in such a model. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1) Secondary efficiency endpoint at T0 (n=1.031): Proportion of cases referred or referred back to the emergency department from the alternative care structure during initial care (T0) or subsequently referred to the alternative care structure from the emergency department after initial referral to the emergency department. 2) Patient-reported outcome measures (PROMS) at T1 (n=344): Patient satisfaction (ZUF-8), Health-related quality of life (EQ-5D) and Health System Responsiveness. 3) Patient safety and quality of care at T0 (n=1.031) and T1 (n=344), measured by: Adverse events at T0 (n=1.031) and T1 (n=344) (analysis depending on the sufficient number of cases): a) mortality (T0 and T1), b) unplanned inpatient readmission within 30 days (T1), c) unplanned (re-)admission to the ICU within 30 days (T0 and T1), d) unplanned re-attendance at the ED within 30 days (T1). 4) Further clinical outcomes (analysis depending on the sufficient number of cases): Length of inpatient stay, frequency of ICU stay, length of ICU stay at T0 and T1, if applicable. 5) Economic evaluation: Cost analysis at T0 (n=1.031) and cost-effectiveness analysis at T1 (n=344), captured with costs and effects. On the cost side, the following outcomes are collected: Services performed and resources used at T0; patient-reported utilization of health care services between T0 and T1, recorded at T1 and evaluated according to the uniform assessment standard (EbM) of the Federal Association of Statutory Health Insurance Physicians (KBV), including diagnostic and therapeutic measures, prescribed medication, hospitalizations; loss of earnings, recorded by days of incapacity to work between T0 and T1, recorded at T1. The above surrogate parameters of patient safety are defined as effects for the cost-effectiveness analysis: Unplanned inpatient readmission within 30 days (T1), unplanned emergency department readmission within 30 days (T1). | — |
Countries
Germany
Contacts
Public ContactAnna Slagman
Notfallmedizinische Versorgungsforschung (CVK, CCM), Charité - Universitätsmedizin Berlin
Outcome results
None listed