Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
BMC Fam Pract. 2021 Apr 14;22(1):72. doi: 10.1186/s12875-021-01418-8.
High continuity of care has a positive impact on health outcomes, but insight into the mechanisms underlying this impact is limited. Information continuity, on which our study focuses, is especially important when relational continuity is not given, which is often the case at hospital admission or hospital discharge. The aim of this study is to provide insight into the information flows between general practices and hospitals in Germany, and to identify factors associated with these flows of information.
This is a qualitative interview study in a purposeful sample of staff from hospitals and general practices (general practitioners, care assistants in general practice, hospital management, hospital physicians, and nursing staff). Interviews were conducted via telephone or face-to-face using a self-developed semi-structured interview guide. Stepwise systematic content analysis was used to structure collected material into themes and sub-themes that related to the study aim. Data was analysed by two researchers in several cycles, alternating between inductive and deductive approaches.
A total of 49 interviews were conducted. Duration of the interviews varies between 21 and 78 min (mean duration 43 min). Across all groups, more than two thirds of participants were female (n = 34, 69%). The analysis highlighted six interdependent main themes regarding factors that affect information flows between hospitals and general practices: organisational, legal, financial, patient factors, individual characteristics, and emotional & social factors. The latter theme emerged as particularly rich and was therefore divided into four subthemes: appreciation and understanding of the respective other, (intrinsic) motivation, socialisation, and relationships. Organised meetings and events were mentioned as strategies to address emotional and social factors.
Digitalisation can facilitate information flows between care providers. However, knowing each other and good personal relations remain important for effective collaboration. Cooperation between all stakeholders is needed to aim to achieve continuity of care.
DRKS00015183 on DRKS/ Universal Trial Number (UTN): U1111-1218-0992. Date of registration 23/08/2018.
高连续性的医疗照护对健康结果有积极影响，但对这一影响背后机制的了解有限。我们的研究重点是信息连续性，在没有关系连续性的情况下（这在住院或出院时经常发生），信息连续性尤为重要。本研究旨在深入了解德国的一般实践和医院之间的信息流动，并确定与这些信息流动相关的因素。
这是一项在医院和一般实践（全科医生、一般实践护理助理、医院管理人员、医院医生和护理人员）的特定样本中进行的定性访谈研究。访谈通过电话或面对面进行，使用自行开发的半结构化访谈指南。采用逐步系统的内容分析，将收集到的材料组织成与研究目的相关的主题和子主题。研究人员通过两个研究人员在几个周期中交替使用归纳和演绎方法对数据进行分析。
共进行了 49 次访谈。访谈的持续时间在 21 到 78 分钟之间（平均持续时间为 43 分钟）。在所有组中，超过三分之二的参与者为女性（n=34，69%）。分析突出了影响医院和一般实践之间信息流动的六个相互依存的主要主题：组织、法律、财务、患者因素、个人特征和情感和社会因素。最后一个主题出现得尤为丰富，因此分为四个子主题：对对方的欣赏和理解、（内在）动机、社会化和关系。组织会议和活动被提及为解决情感和社会因素的策略。
数字化可以促进医疗提供者之间的信息流动。然而，相互了解和良好的人际关系对于有效的合作仍然很重要。需要所有利益相关者之间的合作，以实现医疗照护的连续性。
DRKS00015183 在 DRKS/通用试验编号（UTN）：U1111-1218-0992 上注册。注册日期为 2018 年 8 月 23 日。
