Discharge management ensures in Germany that you are well cared for at home after a hospital stay. However, you can only use this service if you have health insurance in Germany. Since October 2017, there are clear regulations on which services you have a right to within the scope of discharge management (the framework contract was last updated in December 2020). If you don’t want the hospital to organize the follow-up treatment for you, just don’t agree to the discharge management in written form. You can still get prescriptions for individual services but not the whole package. If you agree to the discharge management, the hospital must organize the following services:
If you’re not able to do certain activities at home on your own due to the treatment in hospital, you receive help from a mobile care service. If people from your private surroundings help you, your health insurance pays for them as well. How to apply, read here.
Within the framework of discharge management, a follow-up rehabilitation is often prescribed in order to recover after a longer hospital stay and return to work. The hospital doctor decides whether the rehab should take place in a rehabilitation clinic or on an outpatient basis for the whole day. You pay 10 euros for each day in a rehabilitation clinic, this does not apply to an outpatient rehab. Here you can find suitable rehab clinics for different areas such as orthopedics, cardiology or psychosomatics.
Certificate of Unfitness for Work
The hospital doctor can issue a certificate of unfitness for work (Arbeitsunfähigkeitsbescheinigung, AU) for up to 7 days after discharge. Alternatively, you can contact your family doctor to get the certificate. If you are still not fit for work after the first certificate of unfitness for work has run out, your family doctor can issue a new certificate. Just like the certificate of unfitness for work, this new certificate has to submitted to your employer and if necessary to your health insurance.
Aids & Medicine
If required, the hospital doctor can prescribe dressing material, medicine and aids for up to seven days. Assuming that a patient suffered severe injuries to their legs and they cannot walk anymore, the hospital doctor prescribes crutches. That way, the patient doesn’t have to visit his family doctor after discharge and ask him to prescribe the necessary aids. The same applies to medicine, for example painkiller. If a more long-term basis therapy is necessary, the family doctor or a specialist can give advice.
Sociotherapy & Physiotherapy
If a patient needs psycho-social support after discharge from hospital, hospital doctors can prescribe sociotherapy within in the framework of discharge management. The maximum period of seven days applies here as well. The patients are visited by a sociotherapist at home who helps them coping with everyday life and cares for the psychotherapeutic follow-up treatment. The organization of physiotherapy is similar, however, this takes place in a physiotherapeutic practice.
On the day of discharge, the patient receives a discharge letter. It contains personal patient data, medical findings, the name of the treating doctor and his phone number for questions, as well as recommendations for follow-up treatment and information on drug therapy. The clinic must inform the doctors who carry on the treatment and the care services in due time before discharge about the necessary follow-up treatment. The discharge letter also lists all prescriptions (e.g. for certain aids) and establishments that carry on the treatment (e.g. rehab clinic). A medication plan will be handed out separately to the patient.
Organization of further Medical Treatment
It is complicated to figure out for the patients which appointments are important after discharge. The hospital doctor initiates the further treatment by colleagues by sending them the relevant information at the time of discharge. During the hospital stay, appointments with the doctors who carry out the further treatment can already be made so that there is no medical supply gap.
Transition to a Nursing Home
If it becomes apparent during the hospital stay that a patient is in need of nursing care and needs a place in a nursing home, an employee of the clinic helps them find a care place. Relatives can also get help with the filing of the application for social welfare if the financial resources are not sufficient to cover the nursing home costs.