Skip to main content

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

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.

Author information

Authors and Affiliations

Authors

Rights and permissions

Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reprints and Permissions

About this article

Cite this article

Rümenapf, G., Geiger, S., Godel, A. et al. A new case management concept to decrease the rehospitalisation rate in heurischemic. BMC Proc 5 (Suppl 6), P326 (2011). https://doi.org/10.1186/1753-6561-5-S6-P326

Download citation

  • Published:

  • DOI: https://doi.org/10.1186/1753-6561-5-S6-P326

Keywords

  • Case Management
  • Incisional Wound
  • Historic Control Group
  • Revolving Door
  • Arterial Revascularization