Small hospitals are a risk for the patient? Professionals see it that way. In a study for the Bertelsmann Foundation, sign up with a radical proposal to word.
The care of patients in Germany could be improved to a study by the Bertelsmann Foundation, according to a result of the closure of more than half of all hospital significantly. If the number of hospitals is declining, from just under 1400 to less than 600, could receive the remaining houses significantly more personnel and better equipment, – stated in the published on Monday a study commissioned by the Bertelsmann Foundation. In the case of hospitals and Physicians, the recommendations met with strong criticism.
Better less accessible, but it?
Federal Minister of health, Jens Spahn (CDU) called for a Mix of close to the home supply and specialization. “Not every hospital has to do everything. Here we should combine our forces better,“ he said. “More complicated cases, in a hospital, in the treatment Routine.” Because the quality of a treatment together hanging strong with the experience of the hospital. Clinics, where these necessary Routine lacks to stand already now no compensation for this treatment.
The idea that the hospital is thinned supply, especially in rural areas, raises many concerns. Such a move would also speak to the demands of the Commission “equivalent living conditions” after securing an accessible, close-to-home health infrastructure is reflected. The German hospital Association warned of a “destruction of social infrastructure in a downright adventurous proportions.” Spahn had recently emphasized: “A hospital is a piece of home is, for many citizens.”
Reasons for the closure of the hospitals:
- The remaining hospitals, significantly more staff would be available. In large clinics, specialist offices could be occupied, therefore, better.
- In addition, better facilities in the hospitals would be ensured, resulting in more specialized treatments would be possible.
- In addition to the skills shortage, could be reduced under occupation in the nursing staff.
Supply problems will not be solved
Federal medical chamber President Klaus Reinhardt called the proposal from the experts “more than strange”. In urban areas, larger structures could be “quite reasonable”, he admitted. The doctors ‘ Union Marburger Bund said: “supply problems are not solved in that package regional, easily accessible supply capacity to be thinned.”
“Only hospitals with larger departments and more patients have enough experience for a safe treatment”, by contrast, stress the authors of the by the Berlin Institute for health and social research (Iges) study. Small clinics do not have often the necessary equipment and experience to be able to life-threatening emergencies such as a heart attack or a stroke in appropriate treat. Many complications and deaths could be due to the concentration of Doctors and nursing staff and equipment in fewer hospitals to avoid.
Good accessibility even in less clinics
This assessment was “absolutely empty”, the hospital company said. The quality of care in the hospitals will be measured for years, with few exceptions, each year will be confirmed to all participating hospitals a high level. In the case of a majority of the hospital treatments, it was basic medical care, such as births or age-related diseases of Internal medicine. You would have to “as families and close to home in-reach hospitals” are provided.
In the Bertelsmann study, however, the quick accessibility of a small hospital was only a perceived advantage. If there is no specialist was available, the clinic is a serious quality drawback. As a rule, the hospitals would have to reach within 30 minutes, if your would reduce the overall number significantly. In rural counties with a low population this density, however, is hardly possible, the authors. This applies to a total of 28 districts in eight States.
Number of clinics should be significantly reduced
The debate on a reduction in the number of hospitals in Germany is not new. “Accessibility and quality of the handles are for a long time in a state of tension,” said Jürgen Wasem, Professor of medical management at the University of Duisburg-Essen, the German press Agency. “There are already a lot happening. With the hospital’s structural funds, the merger and the closure of hospitals will be supported financially.“
The authors of the Bertelsmann study, propose a two-stage construction of a new hospital structure. In addition to supply hospitals with an average of 600 beds, there should be about 50 University clinics and the other a maximum of utility with an average of 1300 beds. Currently, a third of the German hospitals less than 100 beds.
“Accessibility is also important”
Strong criticism has caused the study in Mecklenburg-Vorpommern forth. The health policy spokesman of the CDU parliamentary group, Sebastian Ehlers, said on Monday, in addition to the quality of treatment, the accessibility of clinics for people to play a big role.
The hospitals in rural areas would have to remain the same, he urged. After the other had gone there already a lot of infrastructure lost, always with the arguments of professionalisation and cost-efficiency. “These arguments are not important, but the only arguments,” said Ehlers. A quality debate is needed, the hospitals in Mecklenburg-Vorpommern is not, moreover, be afraid to.
Criticism of study
Also in the case of hospitals and Physicians, the recommendations have met with resistance, including the hospital Association of Mecklenburg-Vorpommern. Better care through less clinics – this is the result of the study does not meet MV, – said the head of the hospital Association of Mecklenburg-Western Pomerania, Hanns-Diethard Voigt, compared to the NDR. In the North-East had been closed in the past 20 years, twelve clinics, the structure change is completed. There is a need in the next five years, certainly no action. The clinics in the country were all well equipped.
A Problem of shortage of staff, however, is. In last time had to close therefore individual stations in clinics. 1. July up to 30. September, the delivery room of the DRC is closed-hospital Neustrelitz (Mecklenburg lake district). The children’s ward at the Asklepios hospital, Parchim is since Pentecost sealing. 22. to 28. December 2018, the Mediclin hospital in Crivitz (district of Ludwigslust-Parchim) was his delivery room, due to shortage of staff, going.