AOK Federal Association
Berlin (ots)
The planned transfer of hospital treatment to the outpatient area as part of the forthcoming hospital reform and the quality-oriented concentration of hospital services at fewer locations can also make important contributions to solving staffing problems in German hospitals. This is shown by the current hospital report by the Scientific Institute of the AOK (WIdO) on the subject of “staff”. On the occasion of the publication of the report, the AOK federal association demands that the federal and state governments do not lose sight of the central goal of better quality of care for patients in the reform consultations.
In the case of the so-called “short-term residents”, who are treated as inpatients for less than four days, there is great potential for avoidable hospital days and thus also for relieving the burden on the staff in the clinics, emphasized Prof. Jürgen Wasem, Chair of Medical Management at the University of Duisburg-Essen and Co-editor of the Hospital Report. “The 30 most common surgical procedures with a low medical degree of severity alone account for around 4 percent of all nursing days in the hospital,” says Wasem. Considering the full potential of “outpatient” surgeries and treatments, many more hospital days could be avoided. The planned reform of emergency care also opens up opportunities for personnel relief. In Germany, around 50 percent of emergencies are hospitalized, while in the Netherlands it is only 32 percent and in France 22 percent. “All in all, the hospital reform currently being discussed offers a whole range of starting points for the urgently needed relief of the staff in the clinics and for a better allocation of the available workers,” said Wasem.
German staff treats more cases in an international comparison
The number of doctors and nurses employed has risen continuously in recent years, but in an international comparison, the staff in German clinics treat more cases on average than the employees in other countries. The international average in 2019 was around 12 doctors and 27 nurses per 1,000 hospital cases, while Germany was well below this value with around 8 doctors and almost 19 nurses per 1,000 cases. “We don’t have enough staff for the high number of hospital cases in Germany,” Wasem summarized the problem. Due to the slump in the number of hospital cases in the corona pandemic, there will be more doctors and nurses per case in 2020 and 2021. “However, there were also many Covid infections among employees during the omicron wave, which probably nullified this effect,” says Wasem.
Long-term trends will further aggravate the personnel situation
In addition, according to the hospital report, some long-term trends will tend to exacerbate the staffing situation in German clinics over the next few years. This includes the demographic development, which will lead to an increasing use of hospitals. Preliminary data from the Federal Statistical Office on the decline in the number of nursing trainees and the high exit rates for the professions in the hospital are also cause for concern: “For example, after twenty years only 60 percent of nurses are still working in their original profession ‘ Wasem said. More than half of the unskilled workers changed their profession after two years. Many clinics have great problems finding employees. “There is a very low job-specific unemployment rate – we have practically full employment in this area.”
Hospital report shows possible solutions
The Hospital Report 2023 shows some solutions to increase the attractiveness of hospitals as employers. This includes better offers to reconcile family and career as well as the implementation of concepts for innovative personnel management. The planned reforms in the hospital sector could lead to the emergence of large and well-staffed hospitals that could also react more flexibly to isolated bottlenecks – for example by setting up staff pools across the specialist departments, Wasem emphasized: “The limited human resources could be much more targeted and rational be used if the federal and state governments consistently implement the quality-oriented concentration of services.”
Reimann: Opening clauses must not counteract patient safety
The Chairwoman of the Board of Directors of the AOK Federal Association, Dr. When presenting the report, Carola Reimann pointed out that improving the quality of treatment for patients should remain the central goal of hospital reform and should not be left behind in the current negotiations between the federal and state governments: “In view of the still widespread occasional care, something urgently needs to change here. It must not happen that this goal is thwarted by flimsy regulations or opening clauses at the expense of patient safety.”
Analysis shows that many deaths in cancer patients are avoidable
For example, too many patients are still being treated outside of oncological centers, although the study “Effectiveness of care in oncological centers” (WiZen) has shown a survival advantage with treatment in a center certified by the German Cancer Society (DKG). Reimann presented a current analysis by the WiZen authors, according to which around 4,700 deaths of cancer patients in Germany every year within the first five years after diagnosis could be avoided if their care were concentrated in DKG-certified centers. The concentration of stroke care on so-called stroke units with adequate equipment also results in a similarly large potential for avoiding deaths. The two examples are “very drastic evidence that a quality-oriented reform of hospital structures is necessary,” said Reimann.
Reimann: Extensive investments from the public sector are necessary for the conversion
The urgently needed modernization of care can only be carried out step by step and should begin with the assignment of service groups to the hospitals, stressed Reimann. From the point of view of the AOK, these groups are the “heart” of the reform. “On the basis of the service groups, clear care orders can be defined that are based on concrete structural requirements and are geared to the needs of the population,” says Reimann. It is not about a “cold cleanup”, but about a “cleverly planned, intelligently controlled and clearly quality-oriented restructuring of the structures”. Such a conversion could lead to a more economical use of resources. “A well-organized hospital landscape also ensures that the existing human resources are used more sensibly than before and that the working conditions for the employees improve in the long term as a result.” However, the reform can only succeed with “extensive investments from the public sector”, which are necessary for the conversion of the hospital structures.
Press contact:
Your contact person in the press office:
Dr. Kai Behrens
Phone: 030 / 34646-2309
Mobil: 01520 / 1563042
E-Mail: [email protected]
Original content from: AOK Federal Association, transmitted by news aktuell