Save money, increase supply
Lauterbach is planning large-scale emergency reform
January 16, 2024, 3:10 p.m
The Federal Minister of Health announces a reform of emergency care in Germany. The aim is, among other things, to reduce the burden on existing outpatient clinics. The switch to the new system is scheduled to take place next year.
In the future, patients with acute symptoms should be treated in a hospital emergency room far less frequently. The aim of a large-scale emergency reform by Federal Health Minister Karl Lauterbach is to ensure that those seeking help are increasingly sent to a nearby practice on the phone or on site in the hospital. Insured people should also receive direct telemedical care to a much greater extent than before. Overall, a “major reform” is planned with “incredibly great potential to save money and at the same time improve care,” said Lauterbach.
Today, emergency clinics are often overcrowded – medical organizations have been complaining for years that many people come there with minor complaints, especially on weekends. Lauterbach explained that 25 to 30 percent of cases from emergency rooms can also be treated in doctors’ offices.
The emergency rooms are to be merged into new integrated emergency centers in the future. Lauterbach announced that there should be one center for every 400,000 residents. These centers should also include an outpatient emergency service practice in the immediate vicinity. The assessment of where patients should be cared for should take place at a so-called shared counter.
Appointment service points are to be expanded
At its core, the reform aims to ensure that patients are treated where it is best and quickest, said Lauterbach. “It doesn’t always have to be the hospital,” said the SPD politician. “In many cases, emergency acute care makes much more sense.” A visit to the family doctor’s office the next day is often enough.
The appointment service points of the statutory health insurance associations, which can be reached on 116117, are to be expanded. They should be networked with the rescue control centers that can be reached on 112. In the future it should not matter which of the two numbers you choose. Patients should then receive an initial assessment of where they should go. If an emergency patient dials 116117, he should be able to have an ambulance sent to him, for example.
Telemedicine should also be expanded, as Lauterbach explained. If the doctor does not consider a visit to the practice or clinic by telephone or video to be necessary, then an electronic prescription or an electronic sick note should also be able to be issued. The treatment case can then be completed without those affected having to leave the house, says Lauterbach.
The new reform is scheduled to come into force in 2025
The new emergency centers should also network with the appointment service points. According to Lauterbach, this should make it possible for people to be offered appointments for further treatment there. The reform should be launched in the federal cabinet in the first half of the year and apply from the beginning of 2025.
The Berlin Association of Statutory Health Insurance Physicians (KV), where Lauterbach presented his proposals, rated the plans positively. “More resources are required for more services,” warned KV chairman Burkhard Ruppert. Additional staff and sufficient funding are necessary. Intensive care physician Christian Karagiannidis, who became known during the corona pandemic, called for speed with the planned reform. “If you look at who comes to the emergency rooms in Germany, you can see that an extremely large number of 80- to 90-year-olds go there,” Karagiannidis told the “Ärzte Zeitung”. They often focus more on a supply problem than on a serious illness.
The Greens also supported Lauterbach’s reform plans. Today there is “a toxic simultaneity of over-, under- and incorrect care,” said Green health expert Janosch Dahmen. The reform is overdue. “In this way, emergencies that require the structures of a hospital but not a stay in one can be better cared for in the future.” A regulation to finance special outpatient emergency care such as teleemergency medicine, emergency care teams, community emergency paramedics and psychiatric crisis services should avoid unnecessary transport and inpatient hospital stays.