Status: 05.12.2023, 15:36 PM
By: Andreas Schmid
German hospitals are often overburdened: too few staff, too many patients. But there is at least a solution, says the health insurance company Barmer.
Berlin – Germany's hospitals are cramped. Many hospitals are overloaded, too many beds are occupied. The health insurance company Barmer now calculates: 1.3 million hospital stays are avoidable. The Federal Statistical Office counts around 2022.16 million hospital treatments for 8, so fewer patients would actually noticeably relieve the burden on hospitals. To do this, however, a certain group of patients would have to be treated elsewhere than in hospital.
Family doctor and nursing home instead of hospital
This refers to people in need of care, as stated in the Care Report 2023, which Barmer presented on Tuesday. A total of one in four hospital patients is in need of care, it says. According to the study, between 2017 and 2022, around 280,000 patients in need of care and about to be in need of care were treated in a hospital every month. According to Barmer, these were often cases that could be treated by a family doctor or in a nursing home under better medical conditions.
It mainly affects people with heart failure with around 15,900 hospital cases per month and diabetes with about 4000 cases. "With more targeted care in advance, people in need of care with corresponding illnesses usually do not have to go to hospital in the first place," explained study author Heinz Rothgang from the University of Bremen. "But for this to happen, the framework conditions have to be right."
Hospital beds stand in a corridor in a hospital. How can hospitals be relieved? According to Barmer, politicians are also called upon. © Lukas Barth/dpa/Symbolbild
In this way, care is to be strengthened
To make things better, the experts are calling for an expansion of short-term care. This is because hospital stays are significantly longer if care has to be organized afterwards. Those who come to the hospital already in need of care must expect up to 2.7 days more hospital time, explained Rothgang.
In particular, chronically ill people and those in need of care are often not given the best possible care either on an outpatient or inpatient basis. "The system doesn't work," said Christoph Straub, CEO of Barmer. "To change this, we urgently need new, more efficient care structures. These can be, for example, cross-sectoral care facilities close to home." In other words, smaller facilities with a focus on on-site care.
Such cross-sectoral facilities would have to be established by the federal and state governments as part of the hospital reform currently being discussed, Barmer said. In addition, it is important to strengthen the nursing profession. "The shortage of skilled workers is well known and is also increasing in nursing." How is the situation supposed to improve? "Better working conditions and money alone will not solve the problem," says Barmer boss Straub. "The nursing profession must be sustainably upgraded." In concrete terms, well-trained nurses could take over medical services and thus in turn relieve the burden on hospitals.
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But it is also clear: "We have the problem of avoidable hospitalizations especially among those in need of care, but not only here," said Rothgang. For example, clinics repeatedly complain about people who come to the emergency departments even though they are not emergency patients. A few months ago, the Union therefore already brought an emergency admission fee into play. Anyone who comes to the emergency room without an ambulance service or prior medical advice by the emergency number 112 or the medical on-call service 116117 should pay 20 euros.