[Implementation of discharge management in the surgical department of a university hospital: exploratory analysis of costs, length of stay, and patient satisfaction].

BACKGROUND

Discharge management has been mandatory by law in Germany since October 2017, and hospitals are required to finance and implement this. Currently there are no data available on the costs and effects of discharge management on the length of hospital stay.

AIMS

Determination of the costs of discharge management in the Department of Surgery at the University Hospital rechts der Isar of the Technical University of Munich, Germany, assessment of the length of stay in comparison with and without discharge management, and evaluation of patients' satisfaction to create first precedents for future negotiations about adequate financing.

METHODS

Cost analysis of discharge management in the Department of Surgery at the School of Medicine at the Technical University of Munich, retrospective analysis of the mean length of hospital stays before and after implementation of discharge management, and patient surveys on the quality of the structured transition process and their satisfaction.

RESULTS

The cost analysis revealed lump costs of € 43 per patient and € 391 for patients with a need for complex management. No statistically significant shorter length of hospital stay after the implementation of discharge management was found by analyzing three patient subgroups. The overall rate of patients returning to the hospital due to complications associated with the surgical procedure was 3.4%.

DISCUSSION

Discharge management in the Department of Surgery at the hospital is an effective and potentially quality-enhancing but at the same time cost-driving measure, which, in the medium term, will enter G‑DRG rates and may thus increase costs. A possible solution to meet various stakeholders' needs could be a case-specific financial remuneration of discharge management that is adapted to the transition qualities of the various medical departments.