The largest healthcare construction project: “Individual practice has no future”
Professor Straub, where would you rather be in a hospital: Germany or Switzerland? Straub: It's really difficult for me to support Germany on this issue. We have a shortage of personnel, disorganization, and a massive decline in medical potential. I'm not talking about a shortage of physicians, but part-time models… Professor Straub, part of the government commission on the largest healthcare construction project in Germany, argues that individual practice has no future. He argues that the country is facing a shortage of personnel, disorganization, and a decline in medical potential due to part-time models and changing understandings of work-life balance. The main proposal is to reduce the flat rates per case to reduce barriers to hospital admission. However, the proposal was reduced to a certain level of care based on equipment, qualifications and experience. In the future, it is possible to set minimum requirements through so-called performance groups, leading to greater differentiation of specialist departments and acceptable treatments in individual hospitals. However he is skeptical that the Transparency Act will improve health care.
Publicados : 2 anos atrás por Elizabeth no Health
Professor Straub, where would you rather be in a hospital: Germany or Switzerland?
Straub: It’s really difficult for me to support Germany on this issue. We have a shortage of personnel, disorganization, and a massive decline in medical potential. I’m not talking about a shortage of physicians, but part-time models and changing understandings of work-life balance are reducing available opportunities. Scarce staff should be used where it makes sense, and we need to do a better job sharing between medical and nursing staff.
This is why Health Minister Karl Lauterbach is planning hospital reform. Professor Augursky, you are part of the government commission on this issue: What remains of your proposals?
Augursky: For example, the main recommendation is to reduce the flat rates per case to reduce barriers to hospital admission. In turn, there should be a fixed retention fee. However, the proposal was reduced: each hospital should be assigned a certain level of care based on its equipment, qualifications and experience. It is positive that in the future it will be possible to set minimum requirements through so-called performance groups, which will lead to greater differentiation of specialist departments and define acceptable treatments in individual hospitals. This is a pretty good compromise.
The “levels” are now determined by a separate transparency law currently before the Bundestag. A good way out?
Straub: Only to a limited extent, because this is not about necessarily separating hospitals, but rather about giving patients an idea of which clinic can do what. Such information portals have existed on the Internet for a long time. Our experience is that they do not have a significant impact on decisions about where patients receive treatment. I am extremely skeptical that the Transparency Act will improve health care.
How important is it to concentrate complex interventions on fewer homes?
Augursky: We can show that the results of many oncological operations are better if many of them are performed in the clinic. This is not surprising, but we still need to clearly tell patients: go where there are specialists who do a lot of operations in their field!
Are there really too many and incorrect treatments in German clinics?
Straub: Clearly, many more artificial hips and knees are used per resident than anywhere else, and more heart surgeries are performed. As for poor treatment, strokes are still treated in clinics where there is no stroke department. In Berlin, hospitals that do not have a left heart catheter measuring station treat acute heart attacks. Patients who end up there do not receive proper care. Breast cancer surgeries are performed in institutions without frozen section diagnostics, and these patients also receive inadequate care.
Are the reform proposals going in the right direction?