gms | German Medical Science

Introduction: While numerous activities and policies have been developed in Germany to strengthen health care for people with disabilities following the UN-CRPD, experts continue to report deficits. Studies from diverse health care settings demonstrate that successful cooperation can positively influence health care outcomes. This is especially true for vulnerable target groups. Since 2015, it has been possible to authorize Medical Centres for Adults with Disabilities (MZEB). According to the law, not only medical but also psychosocial and therapeutic services can be provided in these centres. Thus, the interdisciplinary cooperation is already conceptually provided there and MZEB can play a powerful role in influencing cooperation in the medical care network for people with disabilities.

Aim: The study aimed to analyse the current role and further development possibilities of MZEB as a new form of care in relation to cooperation. The poster presents first results.

Method: Expert interviews with 17 employees from 7 MZEB and 10 external actors who had little or no contact to an MZEB were conducted. These were supplemented by ego-centered network maps. The interviews were transcribed and thematically coded. A case vignette was created for each. Evaluations were both case-related and case-comparative.

Results: All participants report numerous challenges in relation to successful cooperation. First was a lack of interest in cooperation for various reasons, including insufficient time, poor financing, no experience and concerns about competition. Furthermore, cooperation is often difficult, with the result that the success of treatment is difficult to evaluate, as there is little contact to patients, their caregivers or other external actors after the care in the MZEB. Employees also perceive a lack of specialised knowledge and mention that externals often do not have sufficient experience in providing care for the target group. This can lead to misunderstandings and erroneous expectations to the MZEB and for all involved. Employees also highlight ongoing uncertainty because of limited financing. Effective cooperation seems to be given little priority under these circumstances.

Discussion: The potential role of the MZEB for fostering cooperation is described differently by MZEB employees and external actors. While employees place the MZEB in a more overarching function, externals have further-reaching expectations. Despite interviewees describing different possible roles of the MZEB in context of cooperation, the results demonstrate the great importance of cooperation for the effective care for people with disabilities. Care can only be provided in a targeted manner if the actors are and remain in exchange.

Implications: Sufficient time, human resource capacity and dedicated space for cooperation are essential for all actors in the health care network for people with disabilities and must be financed. These constitute essential ingredients if the described challenges are to be overcome and care for people with disabilities is to be improved in accordance with the UN CRPD.