Small clinics are allowed to treat premature babies

Preemies may continue to be treated in small hospitals

12/22/2011

According to a nationwide new regulation, premature babies should in future be treated only in large specialist hospitals. This decision has now been overturned by the Landessozialgericht (LSG) Berlin-Brandenburg, because the increased quality of treatment in large hospitals has not been proven. While the smaller hospitals are happy about the lucrative patients, the German children's aid is disappointed: „ The court rates the profit expectation of clinics higher than the chances of survival of premature babies. "

Smaller hospitals feared the loss of lucrative patients
Deutsche Kinderhilfe reports about 60,000 premature babies born in Germany each year. In the opinion of many doctors, the treatment of these children in large specialist clinics makes sense because they have much more experience in this sensitive area. The Joint Federal Committee (GBA) of doctors, clinics and health insurance companies had therefore made a new regulation, according to which only special clinics with at least 30 cases per year may treat premature babies. This new regulation was to come into force on January 1, 2011, but was initially suspended by the GBA due to the numerous complaints from smaller hospitals.

Among the plaintiffs were more than 40 hospitals from all over Germany, who feared that they would lose many lucrative patients due to the new regulation. Hospitals would earn over 100,000 euros in the treatment of a premature infant, court spokesman Axel Hutschenreuther said. The plaintiffs cited another reason for the longer journeys for the parents.

LSA does not consider improved quality of treatment in specialist clinics proven
The GPA calls for the treatment of premature babies in specialist clinics that can detect at least 30 such cases each year. However, the LSA did not see it as proven that this quantity specification also leads to the assurance of the quality of treatment. Axel Hutschenreuther explained: „The scientific evidence for this was not provided.“ In addition, the judges criticized the GPA for having set very stringent prescriptions for premature babies weighing less than 1200 grams, but did not do so for premature babies weighing between 1200 and 1500 grams. This approach was not consistent, said the court spokesman. The LSA Berlin-Brandenburg is responsible for disputes of this kind nationwide, so that the verdict is valid for all of Germany. While the plaintiffs were delighted with the verdict, the Deutsche Kinderhilfe regretted the decision of the LSA, as the court would have rated the profit expectations of the clinics higher than the chances of survival of the premature babies.

Survival of premature babies very different
Preterm birth refers to infants born before the 37th week of gestation and usually weighing less than 2500 grams. A normal pregnancy lasts 40 weeks. The chances of survival of premature babies are heavily dependent on the week of pregnancy in which they are born and their birth weight. In 2010, a 21-week-old girl weighing 460 grams was born and survived. There are also cases in which the premature babies with only 280 grams of birth weight survived. In the case of the girl, the development was very positive, so that it was able to leave the clinic in April 2011 healthy.

A child born before the 22nd week of pregnancy is usually not viable. Only from the 24th week of pregnancy, the chances of survival increase to about 60 percent. Many premature babies, however, are struggling with major health problems, including kidney malfunction, cerebral hemorrhage, and retinal damage. It can cause mental and physical disabilities. (Ag)

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Preemies after sensational birth well
Preemie with 280 grams birth weight

Image: s.media