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CC BY-NC-ND 4.0 · Gesundheitswesen 2023; 85(S 03): S205-S211
DOI: 10.1055/a-2130-2479
Originalarbeit

Effects of Closure of the Paediatric Department of a District Hospital on Regional Care: Analysis of Patient Flows

Article in several languages: English | deutsch

Authors

  • Luisa Tischler‡

    1   Abteilung Versorgungsepidemiologie und Community Health, Universitätsmedizin Greifswald Institut für Community Medicine, Greifswald, Germany

  • Angelika Beyer‡

    1   Abteilung Versorgungsepidemiologie und Community Health, Universitätsmedizin Greifswald Institut für Community Medicine, Greifswald, Germany

  • Kilson Moon

    1   Abteilung Versorgungsepidemiologie und Community Health, Universitätsmedizin Greifswald Institut für Community Medicine, Greifswald, Germany

  • Wolfgang Hoffmann

    1   Abteilung Versorgungsepidemiologie und Community Health, Universitätsmedizin Greifswald Institut für Community Medicine, Greifswald, Germany

  • Neeltje van den Berg

    1   Abteilung Versorgungsepidemiologie und Community Health, Universitätsmedizin Greifswald Institut für Community Medicine, Greifswald, Germany
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Abstract

Background The consequences of economization and staff shortage in the German health care system strongly affect paediatric care structures, especially in rural regions. It is not known how closures of paediatric departments influence patient flows of surrounding hospitals. Here, we investigate the quantitative effects of closure of the paediatric department of a district hospital and the subsequent opening of an alternative inpatient service on the utilisation of inpatient and outpatient care services of the two neighboring hospitals and the emergency services of the region.

Methodology In the observation period from 2015 to 2019, patient-related data from the three hospitals in the study region as well as data from the rescue service were evaluated.

Results In the year after the paediatric department of the district hospital was closed in 2016, the total number of inpatient cases in the region decreased by 33% (2015: n=1,787; 2016: n=1,193) and then decreased by an additional 11% (2019: n=1,005). The number of outpatient cases decreased by further 8% (2015: n=6,250; 2019: n=5,770). In the last observation year, emergency services were used much more frequently than in the year before the closure (2015: n=398; 2019: n=572). This means an increase of 44%.

Conclusion After the closure of the paediatric department, the total number of inpatient cases in the region fell sharply. However, actual gaps in care apparently did not arise. Before closing, the consequences for the surrounding hospitals should be assessed more precisely. Real gaps in care must be counteracted, e. g. through alternative outpatient services.

Key words

paediatrics - inpatient care - regional care - rescue service - patient flows


Publication History

Article published online:
26 September 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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