[Increasing the efficiency of remote delegated home visits in a rural region of Bavaria: interim results of the VERSORGT am ORT study]

[提高巴伐利亚州农村地区远程委托家访效率:VERSORGT am ORT 研究的中期结果]

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Abstract

Against the background of increasing problems in the provision of medival care in rural regions, the further development of outpatient medical concepts focussing on the imperative of economic efficiency and economy is essential. The delegation of medical tasks to medical assistants (MFA) offers a promising approach to relieve the burden on GPs and to support the provision of sustainable care. The 'VERSORGT am ORT' (VaO) project develops this principle and aims to reduce working hours away from patients by partially shifting delegated home visits to specialised care rooms without compromising the quality of care.Parameters for evaluating the VaO concept were quality of life (LQ) and satisfaction (PZ) of patients through standardized questionnaires, time spent away from patients and distance travelled. An initial data analysis from May 2024 to May 2025 compared the standard in the form of home visits (home visit /HB scenario) with partial transfer to VaO rooms according to the VaO model (VaO scenario) using paired t-tests over two survey time points.The n=134 data sets analysed showed significant differences in favour of the VaO model in the scenario comparison. The mean differences for travel time were MW=1.89 [min], travel time MW=2.79 [min], set-up time MW=0.63 [min], total time MW=5.32 [min] and kilometres travelled MW=1.89 [km] with p-values<0.001. Overall, a 20.9% reduction in working time away from the patient from 25.32 to 20.01 min and a 7.8% reduction in kilometres travelled from 13.34 to 12.30 km were achieved. The psychological component of the patients' LQ improved significantly from MW=52.94 to MW=57.27. The physical sum scale increased slightly from MW=41.01 to MW=43.94. Satisfaction remained almost unchanged.These results indicate that the VaO system can significantly increase the efficiency of GP care in rural areas. Despite a small absolute difference in the figures, the relative comparison already shows the potential and the increased efficiency of this innovative form of care. In addition, the interim evaluation shows that the concept does not lead to negative effects on QoL and patient satisfaction. An expansion to other regions and an in-depth analysis of the outcome parameters in further studies are recommended.

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