Health
Quality and kilometers: What does the clinical atlas bring?
How do I find the right hospital for me? An online portal will provide patients with orientation in the future. photo
© Marijan Murat/dpa
When it comes to a planned operation, many people carefully consider whether the clinic closest to them is the best. An online portal will soon help with the decision – it is not without controversy.
Patients will soon be able to compare the services and treatment quality of hospitals in Germany with a state-run online atlas. This is what the Health Minister plans to say Karl Lauterbach (SPD), which the Federal Cabinet initiated.
The “Transparency Directory” is scheduled to launch in April 2024 and will be an interactive portal that will provide understandable information about what is available at around 1,700 clinic locations nationwide. Criticism came from the countries and the industry. The law is intended to complement a fundamental realignment of the clinics with changes to financing, which the federal and state governments are working on together.
Lauterbach: Quality of care can be improved
Lauterbach said in Berlin: “More transparency is overdue and helps hospitals and patients alike.” Doctors are always asked: “Which hospital is good for what?” Everywhere in Germany, nurses and doctors did fantastic work. Nevertheless, not everyone can do everything. “We still have the situation where there are senior doctors who carry out a knee operation on Monday and an intestinal operation the next day.” Of course, this is not a quality of care that one would like.
In acute emergencies, you usually have to go to the nearest suitable hospital as quickly as possible. The clinic atlas is intended to provide better orientation, but can be clicked through for planned treatments for which you can also drive a few kilometers more to a clinic.
The directory: Specifically, the portal is intended to show whether a hospital offers a service – including with a specialist department. The draft includes 65 such service groups that describe medical services in more detail – such as infectious diseases, ophthalmology, urology or intensive care medicine. For example, you can see whether a cancer operation is being carried out in general surgery or in more specialized cancer surgery, said Lauterbach. Data on treatment experience (number of cases), staffing ratios for specialists and nursing staff as well as complication rates for selected procedures should also be easily accessible.
The data: The clinics should report further data, for example on staff numbers. These will be merged with other quality data, processed and updated via two institutes. Lauterbach emphasized that it was about more in-depth information than existing offers. Consumer advice centers are also pushing for more transparency. The federal association’s health expert, Thomas Moormann, said there is “a patchwork” of different search portals. But you can’t see how successful a clinic’s treatments are for specific problems. In order for a well-made directory to have added value, the actual quality of the treatment results must also be surveyed and reflected in patients.
Expertise and distance: Lauterbach made it clear that a closer look at the quality of treatment in the dense clinic network does not have to lead to much longer distances. He referred to the analysis of a government commission, according to which almost 5,000 more people could survive in the first year after a stroke – if all patients only came to clinics with special departments (stroke units). If we concentrated on the special locations, the average journey time would increase by two minutes to 23.4 minutes.
Warnings: The German Hospital Association (DKG) protested against the classification of clinics according to levels – from basic care close to home to maximum providers such as university clinics. The basis should be the 65 performance groups. If a clinic has few of these, but a lot of experience in certain treatments, it will be assigned to a low “level”, complained the DKG – and the message for patients would be that it would be better to go to a clinic with a higher “level”, even though the quality would be excellent . The German Foundation for Patient Protection said it was right to also display the frequency of complications. However, it is important to prevent younger, promising patients from being given preferential treatment. That would be discrimination against the elderly, the chronically ill and those in need of care.
The role of the states: There had already been a stir about the project in the struggle over the planned general reorganization of the clinics. The states put the brakes on a more controlling function of the “levels” in this reform and insist on their planning sovereignty. The federal government is therefore implementing the transparency law on its own initiative – and it does not require approval in the Federal Council, as Lauterbach immediately said. Bavaria’s Health Minister Klaus Holetschek (CSU) warned of uncertainty and a threat to the acceptance of smaller houses in particular. There is also a risk that larger specialist clinics will be overloaded by minor cases. The chairman of the state department heads, Manne Lucha (Greens) from Baden-Württemberg, warned of further bureaucracy.
The future of the clinics: Lauterbach made it clear that he is still counting on further joint work with the states on the actual hospital reform. There should be a draft law for this. The core is to change the remuneration with flat rates for treatment cases in order to relieve clinics from financial pressure to deal with more and more cases. Instead, they should receive a large share of the remuneration simply for providing offers. This also makes small houses safe, emphasized Lauterbach. And it would be unreasonable to say that in order for a clinic to survive in any case, it must remain non-transparent so that it can continue to bill for poor quality.