Operation: how to find a good surgeon

The result of an Operation hädepends on the experience of the surgeon. Nevertheless, Krankenh&auml offer;users without Expertise in appropriate interventions. Why the search for a specialized clinic is worth

A view in a surgery room: The success of the procedure hädepends on the experience of the surgical team from

Will everything go well? The engagement brings the gewüselect the desired result? What if there are complications? I am lifted in this hospital, well, in the case of this surgeon? Of the can? About 17 million operations took Äprior to doctors in 2016 in German clinics. Many patients düshould result from the previously anxious questions. To answer this, it is not so easy. How to assess – especially as a medical layman – the Qualität of a hospital?

Unzäcountless studies have addressed this issue and demonstrate: How high is the risk h&auml is to die in a hospital, ;ngt längst not only of the disease, because the man was admitted. But also from the experience of the surgeon with the procedure. How often he does this. The correct response to complications. Add to that the apparatus and staffing of the house. Is organized, for example, the intensive care unit smoothly and round-the-clock with Fachkräshops occupied?

Specialized centers instead of fläChen coverage

Politicians and Ädoctors have recognized that such Qualitätskriterien are more important than a möas possible the short distance to the näthe next hospital. Specialized centers and f&uuml clinics;r the basic care, such as appendectomies, or the care of patients with Herzschwäche – so f&uuml looks;r many experts, the future of the German hospital landscape. Many interventions are not more flächen­opaque be offered, but only where there are high numbers of cases and high Qualität möresembled are.

"The time of the surgical Tausendsassas, of all the interventions gleichermaßen is good at, is vorbei", about Professor Albrecht Stier, Pr&auml stresses;President of the German society für General – and visceral surgery (DGAV). "And that is a good thing." The DGAV and the German Krebs­company awarded, in the meantime, certificates für individual operation areas, in clinics, the specific criteria erfücases. Currently, this is almost the only Möurgent für patients, üto inform about a house – apart from the Qualitätsberichten, the need to create each device, the für lay, but mostly unverstähourly are.

Help with Online-search for suitable clinics

  • www.dgav.de/zertifizierung/zertifizierte-zentren.html 

The company für General – and visceral surgery at the awards seal für ten areas. Including interventions of the liver, Schilddrüse and Speiseröhre.

  • www.oncomap.de 

Behind this offer of the German cancer society, centers f&uuml certified;r different cancer surgeries.

  • http://weisse-liste.arzt.­apotheken-umschau.de 

The search engine of the White list (Bertelsmann Foundation) is based on the data that each clinic in your Qualitäreport veröpublished. In addition to the case of the equipment, personnel, patient safety and Hygiene. The display can be limited to clinics, which is a Mindestmaß to Qualität erfücases. Many health insurance companies use the Service on their websites. Also, the apotheken Umschau is a cooperation partner of the White list.

DGAV-certification: the case of pay, personnel, and equipment zämiss

As the Basis of the certification, a Register in the data &uuml serves the surgical;about the treatment of 110 000 patients have been collected. Not only compliance with case-by-case f&uuml numbers;r, a seal of nötig, but also corresponding personnel and equipment. "Für complex interventions on the organs of the rule 24/7&quot is;, erklärt bull. "Around the clock, all days of the week we need a Team that is trained and weiß, how to complications after surgery will have to respond."

More than 300 hospitals currently have a certificate of the DGAV. At least 5000 Euro cost of the necessary Überprüfung für the seal, you für their services to advertise köcan. Approximately every tenth house fell through. Better wären mandatory requirements. Currently, there are only für seven interventions such minimum amounts, such für kidney transplants, complex Opera­tions to the Bauchspeicheldrüse and the installation of küartificial knee joints. More to follow. In addition, you think über – strictly controlled – Exceptions für smaller facilities to which the intervention not häoften durchfüdo, but nevertheless, the Qualitätskriterien erfücases. 

Required case numbers köcould to unnötransparent operations füdo

Hook in the scheme: Krankenhäusers that do not adhere to the case numbers, threatened no consequences. Penalties are provided for, and were reimbursed for the operating costs of the rule. The latter könn­te now ächange. The AOK will k&uuml interventions in clinics that fall below the minimum quantities, ;in the future, don’t pay more, küto completed, the Chairman of your national Association. Perhaps other funds. Due to financial incentives köcould the minimum amounts, however, have the opposite effect: Instead of rare durchgefüled operations in General, not to köcould clinics are trying to required case to pay any price to erfücases – and their patients to unnötransparent surgical interventions drängen.

Anyone who needs to have an intervention, should therefore only to the question of where he best durchfüdo lässt. But also: Is surgery in my case is really necessary? The decision should ausfüannual Beratungsgespräche at in-house or specialist, as well as in the clinic. May zus&auml makes it;addition sense, get a second opinion. In the choice of the clinic, the pure statistics show it is clear: Especially when it is complex interventions and/or life-threatening diseases, increase the rates of success with the case numbers. 

Fünf questions that you should ask your surgeon

  • Wüyou would be in my Situ­ation, and with my diagnosis also of such a surgery?
  • How often have you made such an intervention already? How much experience has your house with ­Patients like me? Should I go to a different house?
  • It will go to me after that intervention with a high probability of permanently better?
  • There are Alternatives to the ­Surgery? There are Behandlungsmöopportunities to advance zu­minimum should try? Läthe surgery can be postpone?
  • What würde happen if I let myself not operate?

However, claim and reality diverge in Germany. The show is about payroll data ­the AOK. Example breast cancer: In a quarter of the Krankenhäusers were operated on in 2015, less than eight patients. The cancer society is calling for a minimum quantity of 100 interventions. This Ideal is not reached once the Hähalf of the üover 800 clinics, make this intervention. Example colon cancer: Üabout 1000 German clinics operated Affected. However, about the Hähalf of the Häuser took before the intervention, less than 23 Times. Für a good Qualität be at least 50 operations are required, says the cancer society.

OP experience influenced the Üsurvival of the patient

This has consequences, as a study of the Technical Universität Berlin. Professor Thomas Mansky, head of the Department of structural development and Qualitämanagement in health care, found: For 20 out of 25 gäan independent intervention hädepends on the number of operations immediately, how many patients die in the hospital.  Häwould have complied with the clinics a minimum amount of wären in Germany, in purely mathematical terms, 280 colorectal cancer patients less in the hospital died, 124 less to do with pancreatic cancer, 74 less in lung cancer. Usually hänot have to leave the patients, the clinic healthy, but for weeks, months, or years lived.

"In Germany, there is just too much opportunity surgery," Christian G&uuml says;most of the Scientific Institute of the AOK. He also calls for operations only in clinics with a sufficient number of cases. Studies show that the fläChen coverage not gefäset würde. Für colorectal cancer patients about wüthe average journey of eight s on 16 kilometers erhöhen. Only two percent of the patients mübiggest be treated further than 50 kilometres from the place of residence.

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