Outpatient supply bridges

Outpatient supply bridges eV (AVb)
purpose	Promotion, support and development of measures in the field of health care as well as the support of self-help and aid groups in the areas of health, age and intergenerational activity
Chair:	Ricarda Möller
Establishment date:	August 2009
Number of members:	186 (as of 2014)
Number of employees:	32 volunteers, one part-time worker, one € 450 position, one position in the federal voluntary service (as of 2015)
Seat :	Bremen
Website:	www.ambulante-versorgungsbruecken.de

Outpatient supply bridges e. V. (until April 2013 Outpatient Supply Gaps eV ) in Bremen is a patient initiative to support health-related self-help with special consideration of the self-determination of those seeking advice. The association is asked for advice nationwide. An essential component are the "feel-good calls", home calls by phone.

In 2009, the association successfully initiated a Bundestag petition with the aim of closing the supply gap during recovery at home after a hospital stay, which arose because many health insurances did not cover the cost of domestic help.

The work of the association has received several awards.

Emergence

prehistory

With the diagnosis- related groups (DRG), a flat-rate and thus cost-saving accounting system was introduced in German hospitals from 2004, which significantly reduced the length of stay of hospital patients. “It fell from 14 days in 1991 to a new low of 8.3 days in 2007.” As a result, recovery shifted to short-term care , rehab or, in many cases, at home. For people in the latter group with low incomes who were dependent on domestic help during the recovery period, this could become a blatant problem - a so-called “supply gap” arose.

In 2008, Elsbeth Rütten, who is involved in social and health care, organized a meeting for the first time in Bremen to deal with this topic. 13 participants, mostly women over 50, exchanged their experiences and decided to get involved, in particular to submit a petition to the German Bundestag . Around 150 health insurance companies were contacted and asked about their statutory benefits after discharge from the hospital. Only nine health insurers answered; Nevertheless, it was found that the health insurances dealt very differently with the provision of domestic help. There were first conversations with individual health insurers. At the same time, communication with the population was initiated through various media reports and attention was drawn to the issue of the “supply gap”.

In November 2008 the former mayor of Bremen Henning Scherf became the patron of the patient initiative.

One of the first events was “It is always the others who have personal responsibility”. Around 150 mostly affected people attended the very emotional meeting; much pent-up despair and frustration were articulated. Two weeks later, another event with the topic of "Ensuring care after hospitalization" took place with around 80 to 100 participants, this time mainly representatives of the various health insurance companies, hospitals, patient advice centers and social services.

Foundation of the association

In August 2009, the non-profit association Ambulanteversorgunglücke eV (hereinafter referred to as AVl ) was founded in Bremen. The first members were the initiator and petitioner Elsbeth Rütten and her colleagues from the patient initiative. The first members of the supervisory board were Christine Huth-Hildebrandt (Frankfurt University of Applied Sciences), Hans-Georg Guese (Mediconsult GmbH, IT solutions in health care) and Frauke Horstmann (nursing scientist).

In the coming months the club managed to gain more and more supporters, including a. Gerd Glaeske (member of the Advisory Council on the Assessment of Developments in the Health Care System), Winfried Brumma (SPD parliamentary group of the Bremen citizenship) and Hermann Schulte-Sasse (then State Councilor and later Health Senator). Furthermore, the association managed to interest the public far beyond Bremen's borders and to draw attention to the problem.

As a result, a “round table” made up of representatives of the health insurance funds and the AVl, as well as a symposium “Outpatient supply gap - from the hospital to helplessness?” Started in the Bremen citizenship.

In May 2010 the AVl opened an independent contact and advice center in Bremen. Humboldtstrasse 126.

petition

Submission and decision of the Petitions Committee

In 2009 the public petition 3694 "Home nursing - outpatient aftercare" was submitted to the German Bundestag. She aimed for the following new regulation in the Social Security Code: "The German Bundestag should decide to re-regulate Section 37 , Paragraph 1 SGB ​​V as follows: insured persons receive (...) in addition to medical treatment, home care by suitable nursing and domestic staff, (...), after a hospital stay, after operations and outpatient therapies, if the individual healing and recovery process so require (...). "

In 2010 the German Bundestag announced the result of its final deliberations and its decision: the petition a) to transfer the material to the Federal Government - the Federal Ministry of Health - and b) to inform the parliamentary groups of the German Bundestag for information. The petition was supported by 1,832 signatories and an additional 20,000 citizens with their signatures.

In September 2010, the Bundestag faction of Bündnis 90 / Die Grünen presented the Bundestag printed matter in the German Bundestag to “close the supply gap after hospitalization and outpatient medical treatment” with, in particular, the demand on the federal government in the sense of the petition, “a bill to amend SGB V to be submitted so that patients, after a hospital stay or after outpatient medical treatment, are entitled to treatment, basic care and / or domestic care if necessary ”.

Consultation and change of law

In 2011 there was a public hearing “Closing the supply gap after hospitalization and outpatient medical treatment” in the health committee of the German Bundestag on the occasion of the printed matter 17/2924, which the Bundestag faction of Bündnis 90 / Die Grünen had submitted.

In a written statement, the expert Gerd Glaeske from the Center for Social Policy in Bremen expressed doubts as to whether the amendment to § 37 SGB ​​V was at all suitable to "close the undoubtedly existing supply gap" and asked whether the amendment to § 38 SGB ​​V on the subject of “domestic help” had to be discussed, which is where the association for outpatient care gaps has now started. The association was represented and listened to by Elsbeth Rütten and Claudia Klöhn.

In January 2012, the proposed amendment, supported by the AVl association in its statement, to change the word “can” to “should” in Section 38 (2) SGB ​​V sentence 1, was implemented. After the Federal Council approved on December 16, 2011, the law was changed: “The statutes should stipulate that the health insurance company provides household help in cases other than those mentioned in paragraph 1 if insured persons cannot continue to run the household due to illness. It can deviate from paragraph 1 sentence 2 and determine the scope and duration of the service. "

The aim of the association's petition was thus achieved: The statutes of the health insurance funds should henceforth stipulate that household help is provided in cases other than those mentioned in paragraph 1 if insured persons cannot continue to run the household due to illness.

Goals and way of working

The Association of Ambulant Supply Bridges makes a contribution to health-related self-help for adults of all age groups, especially the 50+ generation. The target group should be enabled to shape their aging and recovery processes in an active, self-determined and resource-oriented manner. The association works with other self-help groups, associations, health policy bodies and organizations.

target group

The contact and advice center of the outpatient supply bridges is open to everyone with questions about health - regardless of the illness. The target group are those affected, mostly people from the 50+ generation and their relatives.

aims

Extract from the statutes:

"§ 2. 2. Purpose of the association is the promotion, support and development of measures in the field of health care, as well as the support of self-help and support groups in the areas of health, old age and cross-generational activity.

§ 2.3. The association supports and develops help for self-help with social health issues, especially in outpatient pre- and aftercare. The association is active in the area of ​​health and social policy work across the elderly and generations. "

Methods

The association works with methods of health promotion and prevention . He is committed to the Ottawa Charter and its understanding of health. The focus is on the action strategy of "enabling and enabling": This action strategy aims to enable people to "(...) realize their greatest possible health potential". On the other hand, the association advocates health-related interests and tries to influence political factors, for example. The strategy of “mediating and networking” is also taken into account in the work. A large number of collaborations with other "(...) actors inside and outside the health care system (...)" make this possible. The work is intergenerational, inclusive and intercultural - in the understanding of a society of longer life.

working area

The association offers numerous support options:

Advice / help for self-help

The association offers independent advice with the aim of securing a self-determined life in the long term, preferably within your own four walls. Competent information is used to provide instructions and / or help people to help themselves. Here, on the one hand, the action strategy of health promotion, empowerment and enabling, on the other hand, the action strategy of conveying and networking is used. Numerous networks with other actors in the healthcare system and collaborations make this possible. Another focus is on qualified preparation for a hospital stay and the subsequent recovery. Due to the shortened lay times, the recovery process is an area that people should deal with in advance.

Lecture work

The association offers lectures on various health-related topics. The volume is between 50 and 80 lectures per year.

"Feel good calls"

The "feel-good calls" are to be understood as home calls by telephone. The conversations with volunteers serve as an encounter, relief and joy in everyday life. The focus is on empathic listening on the part of the trained callers. The elderly are contacted by volunteers at time intervals, depending on the arrangement. The calls go to almost all federal states.

Dialog between the generations

Under the motto “Generation Future - Connecting Generations”, the Association of Outpatient Supply Bridges brings old and young together. The aim is to promote understanding between boys and older people. The association is active here with various projects such as the “Walk of the Generations”.

Guideline "Well prepared - actively healthy"

The guideline "Well prepared - actively healthy" for preparation for hospital stay and recovery offers information and suggestions on 24 A4 pages. The booklet provides orientation and can be used nationwide.

Structure of the organization

Legal form and organs

The organization is not for profit and does not work for profit.

The supervisory board consists of Hans Georg Güse, Marie-Luise Dierks (co-founder and head of the patient university of the Hannover Medical School ) and Johanne Pundt ( Apollon University of Health Economics Bremen). The supervisory board works on a voluntary basis.

The honorary chairman of the association from the time it was founded until her death in May 2020 was Elsbeth Rütten; She held the management as a 450-euro job . Ricarda Möller is now the board member.

Members

The association has 186 members (as of 2014). Any natural or legal person can become a member.

Employee

In addition to the management, the association has an employee with 20 hours per week, a volunteer with 20 hours per week ( federal voluntary service ) and 32 volunteers.

Memberships

• The parity
• Foundation House Bremen

financing

The association draws its financial resources from donations, grants, membership fees, expense allowances and project funding. The association does not receive any funding according to § 20c SGB ​​V from the health insurance companies .

Partners and supporters

partner

• Accident Fund Bremen
• Future workshop for health and care, district of Diepholz
• seniorenlotse.bremen.de
• State Sports Association of Bremen
• Paracelsus Clinic Bremen
• Ways out of loneliness e. V.
• Active people Bremen e. V.
• Laatzen Senior Advisory Board
• Bremische Bau- und Siedlungsgesellschaft mbH (Brebau)
• Senior Citizens Office City of Karlsruhe

supporter

• Henning Scherf , Mayor of Bremen i. R. (patron)
• Gerd Glaeske, Center for Social Policy (ZeS), University of Bremen
• Ulrike Hauffe , Head of the Bremen Central Office for the Realization of Equal Rights for Women
• Annelie Keil , University of Bremen - godmother of feel-good calls
• Willi Lemke , Special Advisor to the UN Secretary General for Sport for Peace and Development
• Klaus Pierwoß , director i. R. of the theater on Goetheplatz in Bremen
• Gabriela Maria Schmeide , actress
• Elisabeth Scharfenberg , politician (Alliance 90 / The Greens)

Honourings and prices

• 2012: 2nd place project "District plans for older people" (network project)
• 2013: 1st place “Home has a future” for the “feel-good calls”. Nationwide competition Home has a future 2013
• 2013: Bremen Citizens' Prize 2013 (Elsbeth Rütten, initiator)
• 2014: Honoring the Vitalpokal Niedersachsen Bremen for the "feel-good calls"
• 2014: Honor - The 8 best in the northwest for the "feel-good calls"

literature

• Claudia Klöhn: Master's thesis (Public Health / University of Bremen): The phenomenon of the “outpatient supply gap” in the German health system . 2013.
• Claudia Klöhn: The “Outpatient Supply Gap ” - Background, Effects and Solution Strategies , pp. 185–204. In: Wilfried von Eiff, Bernhard Greitemann, Marthin Karoff (eds.): Rehabilitation management . Kohlhammer, Stuttgart 2014. ISBN 978-3-1702-2630-2

Web links

• Outpatient supply bridges
• Feel good calls
• People strengthen people - Elsbeth Rütten and her colleagues from the “Outpatient Supply Bridges” association are looking for sponsors. Weser-Kurier, June 25, 2019, accessed on June 25, 2019 . 

Individual evidence

1. ↑ Press release 473/08: Length of stay in hospitals at an all time low (PDF) Federal Statistical Office. December 10, 2008. Retrieved July 1, 2015.
2. ↑ Maria Klein-Schmeink Member of the Bundestag: Closing the supply gap after hospitalization and outpatient medical treatment (PDF) September 14, 2010. Accessed July 1, 2015.
3. ↑ Bettina Schmidt: Book review: Others always have personal responsibility. The Discourse of Responsibility in Healthcare. Bern: Huber. . Free University of Berlin - Prevention and Psychosocial Health Research Division. June 15, 2008. Archived from the original on July 13, 2015. Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved July 1, 2015. 
4. ^ Carsten Sieling : Ensure care after hospitalization . June 23, 2009. Archived from the original on July 12, 2015. Info: The archive link has been inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved July 1, 2015. 
5. ↑ Model project for post-inpatient care starts in 2010 . Doctors newspaper. November 26, 2009. Retrieved July 1, 2015.
6. ↑ Gerd Glaeske: From the hospital to helplessness? Gaps in post-inpatient care (Download PDF) University of Bremen, Center for Social Policy. November 13, 2009. Retrieved July 1, 2015.
7. ↑ Petition Home Nursing - Outpatient Follow-Up Care . openPetition Germany. May 4, 2009. Retrieved July 1, 2015.
8. ^ Petition 3694 Nursing at home - outpatient aftercare from April 8, 2009 . German Bundestag. April 8, 2009. Retrieved July 1, 2015.
9. ↑ BT-Drs. 17/2924
10. ↑ BT-Drs. 17/2924
11. ↑ Mixed response to expanded patient care . German Bundestag. 2011. Accessed July 1, 2015.
12. ↑ Health insurance supply mandate? . Compliance-Magazin.de. March 20, 2011. Archived from the original on July 12, 2015. Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved July 1, 2015. 
13. ↑ Outpatient gaps in care after hospitalization: controversial discussion in the health committee . Domestic care. March 28, 2011. Retrieved July 3, 2015.
14. ↑ Health Committee: “Are there gaps in care for patients after their hospital stay?” . CARENOBLE Society for Health Economics. April 10, 2011. Retrieved July 3, 2015.
15. ^ Opinion on the draft of a law to improve care structures in the statutory health insurance (GKV supply structure law - GKV-VStG) . Association of Outpatient Supply Gaps e. V .. October 13, 2011. Retrieved July 3, 2015.
16. ↑ BGBl. 1988 I p. 2477
17. ↑ Support offers in Bremen . University of Bremen. Retrieved July 3, 2015.
18. ↑ Search for self-help . Network self-help Bremen-Nordniedersachsen eV. Archived from the original on April 2, 2015. Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved July 3, 2015. 
19. ↑ Edwin Platt: What a rollator can do - Elsbeth Rütten from the outpatient supply bridges explains functions / regular TÜV makes sense . Weser courier. August 31, 2014. Retrieved July 3, 2015.
20. ↑ Ronja Schüttken: Effects of psychosocial care in the form of feel-good calls on old people. (No longer available online.) Neobooks.com, May 21, 2017, formerly in the original ; Retrieved on May 24, 2017 (Abridged Edition).  ( Page no longer available , search in web archives )  Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice.    
21. ↑ Janet Binder: When you call, feel good. Press service Bremen, October 23, 2015, accessed on October 25, 2015 . 
22. ↑ Contacts and mobility . City of Karlsruhe. Retrieved July 3, 2015.
23. ↑ Offer for the district of Diepholz Participation through "feel good calls" . Weser courier. November 23, 2014. Retrieved July 3, 2015.
24. ↑ A walk of the generations . The Senator for Social Affairs, Children, Youth and Women of the State of Bremen. September 2014. Retrieved July 3, 2015.
25. ↑ Guidelines help you plan your stay in the clinic - "Well prepared - actively healthy" . City of Bremen. Archived from the original on September 23, 2015. Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved July 3, 2015. 
26. ↑ Well prepared - actively healthy! . Sozialverband Deutschland eV (SoVD) local association Kirchweyhe. Archived from the original on July 12, 2015. Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved July 3, 2015. 
27. ↑ H. & nbasp; G. Güse, spokesman for the supervisory board: Obituary by Elsbeth Rütten. Outpatient supply bridges, accessed on July 28, 2020 . 
28. ↑ Urban district plan for older people in Walle-Überseestadt published . bremen.online GmbH, State of Bremen. Retrieved on July 3, 2015.  ( Page no longer available , search in web archives )  Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice.  
29. ↑ Our nationwide competition "Home Has Future 2015" took place for the 6th time . Home has a future, ways out of loneliness e. V .. Retrieved July 3, 2015.
30. ↑ The Winner is… 1st place in the competition “Home has a future 2013” ​​goes to the association Outpatient Supply Bridges . The Senator for Social Affairs, Children, Youth and Women in Bremen. Retrieved July 3, 2015.
31. ↑ The finalists for the NordWest Award 2014 have been announced! . Metropolitan Region Bremen-Oldenburg in the Northwest eV. Retrieved July 3, 2015.