Modern hospital admission and discharge management

Abstract

A modern discharge management should be centrally organized but patient allocation management can also be centrally organized in addition to a combination of centralized and decentralized mechanisms. This is substantially influenced by the size (number of beds) and structure (number of specialist departments) of each hospital. With only one or only a few specialist departments centralized organization is the best solution but with many specialist departments a combination of centralized and decentralized management is more appropriate. Further influencing factors are patient structures, such as the relationship between occupational insurance shemes, statutory health insurance and private health insurance as well as the ratio of elective and emergency admissions. In addition, the following factors must be taken into consideration: the rate of inpatient rehospitalization, complex case constellations, intensive care medicine and ventilation diagnosis-related groups (DRG), pathogen colonization/infections, mother/child, patient/relatives and dealing with budgets and remuneration. Taking these influencing factors into consideration a modern hospital admission and discharge management is greatly influenced by responsibility in three respects: 1. medical, specialized, nursing, 2. organizational and 3. economic areas.