Hospital.Help

Berlin – The majority of small and medium-sized hospitals in Germany cannot meet the planned personnel requirements for the service groups that are to be introduced as part of the hospital reform in the status quo. This is shown by a current survey by the German Hospital Institute (DKI).

Accordingly, 60 percent of the regular and specialized hospitals stated that they were able to meet the requirements mostly (70 to 90 percent of the requirements) or only partially (50 to 70 percent). Of the basic supply houses, 82 percent stated that they could not fully meet the requirements.

Six percent of them also stated that they could meet less than 50 percent of the specifications. The situation is different for maximum providers. Here it is 73 percent who can fully reflect the specifications.

The DKI also asked whether the requirements of the corresponding performance groups can be met. The Hospital Care Improvement Act (KHVVG) also provides for the full fulfillment of certain service groups and the fulfillment of other service groups that should be provided at one location.

In primary care, only 19 percent declare that they can fully cover these service groups. For regular and specialized care, the figure is 36 percent. Here, too, maximum providers are better equipped (67 percent).

The big houses also assume that they will win more cases in the future (73 percent). This is only 27 percent of regular and core providers. The majority (49 percent) assume that the cases will remain roughly the same. Small primary care clinics in particular expect the number of cases to fall (59 percent).

The majority of clinics fear reserve funding

A clear picture emerges when asked about the clinics’ self-assessment as to whether they would be adequately financed by the planned reserve financing if the number of cases stagnated or fell. Only five percent said they thought so. The vast majority of clinics (95 percent) have corresponding reservations about reserve funding.

This shows that the reserve funding will not be enough, explained the CEO of the German Hospital Association (DKG), Gerald Gaß, today when presenting the results. “We will experience situations that threaten our existence, and reserve financing will not change that.”

The Hamburg company Vebeto took another look at the planned reserve financing. When analyzing the minimum reserve numbers provided for in the individual service groups, it is clear that only very few hospitals would benefit, said Vebeto founder Hannes Dahnke today. “Most hospitals would lose.”

The minimum reserve numbers for the individual performance groups have not yet been determined. These figures are to be developed under the primary responsibility of the Institute for Quality and Efficiency (IQWIG) and set by legal regulation next year. The prerequisite for this is that the KHVVG comes into force.

Around a third of the clinics assume losses due to minimum reserve numbers

However, for preliminary calculations, Dahnke assumed that the threshold in primary care – including obstetrics, pediatrics and geriatrics – is at the 5th percentile. This means that the smallest locations, which collectively treat five percent of cases in the service group, fall below this threshold and are no longer allowed to offer the service.

For more complex services in basic and standard care – such as gastroenterology, urology, stroke unit – he assumed the 12th percentile, i.e. a threshold of twelve percent. And for all other performance groups, Vebeto has defined the 20th percentile as the limit.

This shows for the whole of Germany that around eleven percent (182 of 1,589 clinics) would receive an increase in revenue if these numbers were activated.

More than half (883) would generate three percent less or more revenue. Around a quarter (409 clinics), however, would experience losses of three to 15 percent, explained Dahnke. Another seven percent (115 clinics) would record losses of 15 percent or more.

According to another survey, the population in Germany is concerned about medical care, explained DKG boss Gaß. More than 5,000 people responded to the representative online survey, carried out by the online survey company Civey.

Almost half of those surveyed are worried about a deterioration in care in their home region due to possible practice or clinic closures. People in Saarland, Saxony-Anhalt and Rhineland-Palatinate in particular fear future hospital closures. © cmk/aerzteblatt.de