AOK Significant treatment differences in clinics

Hospital Report 2011

Hospital Report 2011: Strong Differences in Treatment Quality at Germany's Clinics

10/12/2010

The scientific institute of the AOK (WIdO) has published the Hospital Report 2011, which shows that there are significant quality differences between the various German hospitals. In many hospitals, the risk of complications after surgery is significantly increased - even with routine medical procedures.

Complications also occur during routine procedures
The WIdO comes in the Hospital Report 2011 to the conclusion that in every tenth clinic when using an artificial hip joint 80 percent more complications occur, as statistically expected, explained the director of the Institute, Jürgen Klauber, at the presentation of the report. Among other things, the experts of the WIdO had examined for the current report how often there are complications during routine interventions (eg insertion of a hip joint) in the different clinics. The top ten percent of hospitals have fallen below the statistically expected complication cases by 44 percent in the investigation of the WIdO, the Institute's Managing Director. Comparing the complications that occurred after a routine procedure in the various hospitals within one year also showed that numerous operations had to be performed a second time due to unexpected problems.

Many hip operations had to be repeated
As part of the 2011 Hospital Report, for example, the WIdO examined in more detail the complications after the onset of an artificial hip joint (due to joint wear and tear) between 2006 and 2008. With the result that in every second clinic more than four percent of the hip operations had to be repeated within one year. The 25 percent of clinics with the most complications had to schedule a new operation in more than 5.9 percent of cases. Including all other medical complications, such as fractures, thromboses and pulmonary embolisms, more than 12 percent of patients had complications after surgery in half of the hospitals, explained Jürgen Klauber with reference to the hospital report. In order to avoid distortions due to individual risk of complications for patients, the different distribution of elderly and people with pre-existing conditions was considered in the preparation of the report by the WIdO.

Patients should inform themselves about the quality of the clinic
In view of the widely varying quality of treatment in the various clinics, Jürgen Klauber explained: „The differences can have many causes“, For example, the processes in the hospitals are professionalized to varying degrees. For the patients it is therefore all the more important to have a reliable information about the quality of the respective hospital. „Patients planning a hospital stay need not only information about the service of a house, but above all reliable information about the quality of the treatment“, stressed Jürgen Klauber. The institute's managing director also referred to the evaluation portal for hospitals on the Internet, which provides patients with reliable information on hospital quality in the area of ​​hip and knee surgery as well as operations for a fractured femoral neck. Unfortunately for the experts, despite years of quality measurements in Germany, there is no official list that can be viewed by anyone and shows which clinics are good in which areas. Therefore, patients should seek help from their doctor in finding a good clinic, advises the expert. In addition, the health insurance funds should in his view get more opportunities to conclude special contracts with the hospitals, to enable the insured to increasingly head for good clinics.

Connection between quality and competition
The hospital report, published annually by Max Geraedts of the University of Witten-Herdecke and Jürgen Wasem of the University of Duisburg-Essen together with the Scientific Institute of the AOK (WIdO), primarily assesses the quality of the German clinics. The 2011 Hospital Report covers the connection between quality and competition, the status of in-patient quality assurance in Germany, the importance of quality as a market factor for hospitals, and the use of quality information by patients when selecting a clinic. The report also tries to present concepts with which the quality can be improved either in the existing collective agreement system or by individual contract options of the health insurance funds. (Fp)

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Picture credits: Gerd Altmann