Intersectoral cooperation between university hospitals and physicians in private practice in Germany- where the potential for optimization lies

Abstract

Background: Intersectoral cooperation between physicians in private practice and hospitals is highly relevant for ensuring the quality of medical care. However, the experiences and potential for optimization at this interface from the perspective of physicians in private practice have not yet been systematically investigated. The aim of this questionnaire survey was to record participants' experiences with regard to cooperation with university hospitals and to identify the potential for optimizing intersectoral cooperation.

Methods: We performed a prospective cross-sectional study using an online survey among practising physicians of all disciplines offering ambulatory care in Germany. The link to a 41-item questionnaire was sent via mail using a commercial mail distributor in which 1095 practising physicians participated. Baseline statistics were performed with SurveyMonkey and Excel.

Results: A total of 70.6%/722 of the responding physicians in private practice rated cooperation with university hospitals as satisfactory. Satisfaction with the quality of treatment was confirmed by 87.2%/956 of the physicians. The subjectively perceived complication rate in patient care was assessed as rare (80.9%/886). However, the median waiting time for patients in the inpatient discharge letter was 4 weeks. The accessibility of medical contact persons was rated as rather difficult by 52.6%/577 of the physicians. A total of 48.6%/629 of the participants considered better communication as an equal partner to be an important potential for optimization. Likewise, 65.2%/714 participants wished for closer cooperation in pre- and/or post inpatient care.

Conclusion: The following optimization potentials were identified: timely discharge letters, clear online presentations of clinical contacts, improved accessibility by telephone, introduction or further development of a referral portal, regular intersectoral training and/or "get-togethers", regular surveys of general practitioners and implementation of resulting measures, further development of cross-sectoral communication channels and strengthening of hospital IT.

Keywords: Collaboration; Intersectoral; Optimization potential; Private practices; University hospitals.

Fig. 1

The 15 most frequently mentioned specialties (max. 2 answers). Note: The information is given in each case as a percentage and the absolute number (n)

Fig. 2

Responses regarding the frequency of notifications of complications occurring during inpatient stays and regarding planned follow-up treatments

Fig. 3

Perceptions of the professional and social competence of physicians in cooperating university departments Note: The information is given in each case as a percentage and the absolute number (n)

Fig. 4

Reasons for referral to the university department (max. 3 answers) Note: The information is given in each case as a percentage and the absolute number (n)

Fig. 5

Responses to the question regarding what would benefit the collaboration with the relevant department of the university hospital: “if…” (max. 3 answers) Note: The information is given in each case as a percentage and the absolute number (n)

Fig. 6

Answers to the question about concrete measures to improve cooperation (max. 5 answers) Note: The information is given in each case as a percentage and the absolute number (n)