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Table 3 Participants’ quote for theme “Challenges with ATC as a discharge option”

From: Practicality of Acute and Transitional Care and its consequences in the era of SwissDRG: a focus group study

Quote (Q) Quote from participants
Q3 (...) it’s more work to do ATC [instead of regular spitex (i.e. home health service provider]], frankly, apart from the added value for the patient who doesn’t pay for 14 days the eight francs, right, but all the work hospital doctors have … it’s an administrative tedium, for finally, well, actually, the patient saves 14 times eight francs. (P1, FG5)
Q4 ATC plays a very small role. Well, I remember when they established it, spitex made an event and informed us, what it is and this caused astonishment, because the key question was whether there is a new offer? And, well I assume spitex does what it can. That means from the supply end, it was not plausible that anything was done differently or more was done than before. But if one then calculates where the benefit for whom lies, it was only this nursing care deductible. (P2, FG2)
Q5 We do the registration [for Spitex] electronically … [which], takes two or three minutes administratively, then it is done and sent out. … And for ATC, it looks like, for now they’re asking us to fill in their forms [in addition to the previous information that must be sent], and we must give the same information again. (P2, FG2)
Q6 This is of course what case management does for us, the physician signs it. (…) I would never have come up with the idea of presenting this to a physician, for me it is quite clearly a nursing order, so in my view, the physician cannot do that. (P4, FG1).
Q7 ATC is limited in time, to actually 2 weeks, which, I think, can be extended, I think the average stay is 3 weeks, then the financing simply changes, which then changes to a temporary bed. [...] But the killer criterion is the [limited] time. (P2, FG6).
Q8 And then there are those that are ... the acute transitory care where patients must have the requirements: age AVS [legal age of retirement], therefore 64 for women, 65 for men. An estimated ATC of 14 days where there is the possibility of extending the stay (…) that gives additional 14 days then for a total of 28 days. (P1, FG7)
Q9 It’s true that 14 days are rather short, that is the maximum duration of ATC. Extending ATC to 30 days would not mean to prescribe 30 days for all. It would mean, if 16 days were appropriate, you could give 16 days. It is the moment to assert that 1 month of ATC would be more facilitating than 14 days ATC. (P1, FG5)
Q10 We get those people from the ATC and we first need to find out: What is the goal for that person? What goals does she have how it’s supposed to work at home? Be it taking two steps on the stair or walking around with support. And 2 weeks is simply very short. People often come in a very acute phase. […] (P4, FG2)
Q11 We also always tell that it may not be realistic, the 2 weeks. So with me there is no cheating package by saying after 2 weeks they are fit again and at home afterwards. I rather say that can be 3, 4, 5, 6 weeks.. But it’s also for the patients – I experience sometimes – that they would rather go there [ATC], because they don’t want to stress themselves as for example in a Reha, where there is quite a program to follow within 2 weeks. But [as a patient] I have more time and can relax/recover there with the option – that is my goal – to go back home afterwards. (P3, FG3)
Q12 Yes, well [the cost information] must be told [to the patients] in the hospital, because that sums up extremely and the relatives are relieved when the patient goes to rehabilitation because that is a lot cheaper... That is an aspect, an important one. (P4, FG1)