Hundreds of thousands of unnecessary hospital treatments

Study: hundreds of thousands of unnecessary hospital treatments

07/12/2014

Although the population in Germany has remained almost constant in recent years, the number of treatments in hospitals has increased significantly. The increase can not be explained by an aging population. Appraisers are now proposing measures for improvement.

Treatments increased despite constant population
The number of treatments in hospitals has increased significantly in recent years despite the almost constant population in Germany. According to a study by experts from Berlin and Hamburg, this increase can not be explained by the aging population alone. According to the study, "the number of inpatient hospitalized patients increased by 8.4 percent from 2007 to 2012 to 18.6 million cases, which corresponds to an annual increase of up to 314,000 cases." Above all, plannable interventions would have increased. There were particularly large increases, inter alia, in "interventions on the spine and heart valve operations". Especially on working days during the day, the number of treatments increased.

Debates about potentially unnecessary treatments
The aim of the report, which was initiated by the legislature, was to clarify the reasons for the sharp increase in hospital services. Politicians, doctors, hospitals and health insurances have fiercely debated potentially unnecessary treatments in the past. However, the present report can not clarify clearly whether the increased interventions are really necessary or whether the clinics make them mainly for financial reasons. The ratings were very different.

Different ratings of the results
For example, the umbrella association of statutory health insurance (GKV) and the German Hospital Association (DKG) assessed the study results very differently. From the point of view of the health insurance companies, patients would often also be operated for sales reasons. „The hospitals do what is worthwhile“, says the clinic expert of the health insurance association, Wulf-Dietrich Leber, according to a dpa report. Although the study gives no information as to whether healthy people would be operated on, but in part, the increase can be explained with it, „that some make money with operations.“ The clinical carriers, however, see the main cause in the increasing burden of disease in humans. As the DKG president Alfred Dänzer said, claims that hospitals would provide medically unnecessary services for economic reasons have no basis. It is in the nature of things that new and better treatments for cancer have resulted in increases in case numbers.

Measures for improvement
The experts from the University of Hamburg and the Technical University of Berlin propose measures for improvement in their report. As a result, they demand, among other things, a binding second medical opinion for certain diagnoses, a reorientation of hospital planning and a stronger linkage of remuneration to the quality of care. In addition, the policy should set no volume incentives. One of the politicians who commented on the topic is the CDU health expert Jens Spahn. To the dpa news agency he said: „We should then counteract the possibility of a second opinion and targeted price discounts.“

Less money for clinics with dubious results
SPD health expert Karl Lauterbach said to the „world“, that the second opinion should be paid by the coffers. Costs could be saved if unnecessary operations are avoided. According to Spahn and Lauterbach, it is also considered that clinics with dubious results in certain operations to give less money and pay supplements for primary care hospitals, so that the pressure decreases to earn additional OPs money. The German Foundation for Patient Protection, on the other hand, reiterated its view that surgery was often unnecessary and called for more support and relief, rather than surgery on elderly and dying patients. Germany is the international leader in terms of treatment per capita in the OECD. In the Netherlands there has been a stronger increase, but at a lower level. The Federal Ministry of Health has referred to a working group of the Federal Government and the Länder, which is currently negotiating a hospital reform. (Ad)