gms | German Medical Science

Background: The complex and dynamic situation of the COVID-19 pandemic requires a regionally coordinated and networked cooperation between different providers within the statutory healthcare system. In addition, political requirements determine the structures of pandemic management.

Objective: The aim of this study was to investigate the role of German university hospitals in regional cooperation models focusing on management, clinical care, regional networking and communication structures during the COVID-19 pandemic in 2020/2021.

Method: The project is based on a mixed-method approach. First, an (online) survey of all board directors of 35 German university hospitals querying the inpatient pandemic management at regional level was conducted in November 2020. The questionnaire focused on regional networking, crisis management, data exchange and communication with political institutions. The collected data were analyzed using descriptive and multivariate methods. Second, 32 interviews with experts of the university hospitals were performed in January/ February 2021 focusing on structures and networking in regional inpatient pandemic management. The interviews were evaluated using qualitative content analysis according to Mayring.

Results: The results of 25 completed questionnaires (71.4%) indicate that networking with other health sectors were crucial for all surveyed hospitals, especially in the inpatient sector (68%) and with the public health service (86%). The qualitative analysis indicates that it is relevant to structure all sections in dependence to the care situation and not on political boundaries. These boundaries often lead to problems. Crises, such as the current pandemic, have the potential to trigger or loosen firmly anchored bureaucratic and institutional structures.

Discussion: The results from the questionnaire survey provide an initial analysis of the current regional inpatient pandemic management structures against the background of federal differences and similarities in inpatient care. The initial results reveal the heterogeneous cooperation and key components managing the inpatient situation under pandemic circumstances. The results of the qualitative interviews reinforce this thesis and highlight the need for structured collaboration between the various actors and policy stakeholders on a regional base due to federal differences.

Practical implications: Based on the current state of health care provision and previous experience in dealing with the COVID-19 pandemic, a consensual catalogue of criteria with best practice standards for regionally networked inpatient pandemic management should be implemented. To achieve this goal five expert workshops based on our results will be held in May 2021 to evaluate and discuss the relevance of the results obtained using the Delphi-method.

Appeal for supply: The need for networked collaboration across health care sector boundaries is central successful pandemic management.