Clinics have too little routine
AOK sees deficits in heart attack treatment
April 24, 2024, 4:55 p.m
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According to the AOK, in 2022 numerous cancer and emergency patients will be treated in clinics that are not adequately equipped – although there are regional differences. In order to increase the quality of treatment, the health insurance company is demanding faster specialization of care.
According to an analysis by the health insurance company AOK, there are persistent quality deficits in the treatment of cancer and emergency patients in German hospitals. 18 percent of the hospitals involved in breast cancer care operated on fewer than 25 cases in 2022, according to the AOK’s so-called Hospital Report 2024. “With such case numbers, one cannot assume that there is an experienced treatment team or even a well-rehearsed process chain in these clinics,” explained Christian Günster from the AOK Scientific Institute.
Over 9,000 women with breast cancer were treated in hospitals that were not optimally equipped for this. While in Saxony-Anhalt every fourth operation took place in a clinic that was not certified by the German Cancer Society or a comparable clinic, in Berlin it was only 0.2 percent. The concentration process needs to be accelerated, especially when it comes to cancer treatments. “If we continue at the current pace, it would take 20 years until all patients with cancer are treated in certified centers,” explained Günster. Many heart attack patients also do not receive optimal care.
Big differences between federal states
Of the approximately 191,000 heart attack cases, 4.9 percent were treated in clinics that did not have a catheter laboratory. Around 9,400 people were affected. The problem was particularly clear in those 368 clinics that treated fewer than 25 cases in 2022. Only every fifth clinic in this group has a corresponding laboratory. In this area too, there were sometimes large differences between the federal states. In Saarland, one in nine heart attacks was treated in a clinic without a cardiac catheter laboratory. In Hamburg, however, almost all those affected were admitted to a clinic with a cardiac catheter laboratory. Already in 2018, Saarland and Hamburg were in last and first place respectively.
“Obviously in some federal states there are still major problems in directing patients to the appropriate clinics, because we actually have no shortage of cardiac catheter laboratories in Germany,” explained Günster. The structural reform to improve the quality of treatment should not be decoupled from the financing reform in the planned hospital reform, explained the CEO of the AOK Federal Association, Carola Reimann. Otherwise the law risks becoming an “expensive, empty shell with no positive effects on care.”
Reimann calls for reform of hospital financing
Reimann criticized the fact that the binding definition of the performance groups should only be regulated later. “The requirements as to which clinic is allowed to provide which services in the future would be postponed until St. Nicholas Day,” she explained. At the same time, the money would continue to be distributed to the clinics in a watering can, which would continue to finance “inefficient hospital departments with poor quality outcomes.” This causes suffering for patients and high follow-up costs for contributors. Reimann called for the states to be obliged to only award supply contracts to hospitals that achieve the corresponding minimum reserve numbers.
Such a requirement is missing in the current draft hospital reform. In view of the ongoing decline in the number of cases and falling hospital occupancy, financing reform is urgently needed. Reimann also criticized the fact that half of the costs for the transformation fund to convert the hospital landscape should be paid by statutory health insurance. She called on the federal and state governments to pay the costs with tax money.