Background
Centralisation, i.e. the reorganisation of inpatient healthcare services into fewer specialised units serving a higher volume of patients, affects patients in numerous ways. However, patient representatives’ perspectives on centralisation have hardly been explored.
Objective
This study aimed at eliciting patient representatives’ perspectives in Germany on the advantages and disadvantages of centralising inpatient healthcare services.
Methods
To meet this research aim, focus groups were facilitated. Purposive sampling was based on indications affected by minimum volume standards. In total 21 patient organisations were invited. A semi-structured interview guide on the advantages and disadvantages of centralisation was developed. Two researchers analysed the qualitative data using content analysis.
Results
Two focus groups with 14 patient representatives were conducted in September and October 2022. Participants discussed advantages and disadvantages with respect to treatment, patients, healthcare professionals and the healthcare system. Perceived advantages included improved treatment process and outcomes, lower complexity of care pathways, an improved distribution and less strain of healthcare professionals, and lower healthcare expenditures. Perceived disadvantages comprised the low quality of referrals and low organisational level of follow-up care as well as particularly disadvantaged groups, such as elderly patients, women and caregivers.
Conclusions
Centralisation should not focus on hospitals alone, but should consider all service providers to address challenges at the transition between inpatient and outpatient care. Furthermore, policy measures should be implemented to mitigate disadvantages of specific patient groups. Patients should be involved as they can contribute novel aspects with respect to the configuration of healthcare services.
Stefanie Pfisterer-Heise, Julia Scharfe, Alexander Pachanov, Charlotte Mareike Kugler, Dawid Pieper
Disease Category: Effective practice/health systems
Disease Name:
Age Range: 18 - 120
Sex: Either
Nature of Intervention: Any
- Clinical experts
- Patient/ support group representatives
- Patient perspectives
- Focus group(s)
- Semi structured discussion