Hospitals calculate cesarean births more often than emergency surgeries

More and more expensive emergency surgery for cesarean sections
Since 2009 it has become known that hospitals can bill for emergency caesarean sections more than for a planned caesarean section, the number of emergency surgery has risen sharply. This shows a data analysis by the Techniker Krankenkasse (TK). Decisive for the increase is apparently the "economic incentive".

More and more cesarean births
According to figures from the Federal Statistical Office in Wiesbaden, almost every third child in Germany is born by caesarean section. Many women seem to be so afraid of labor and delivery that they choose not to have a natural childbirth and prefer to give birth to their child by caesarean section on a pre-scheduled appointment in the OR. But there are also many medical reasons for a planned procedure. For example, when the baby is in the pelvic position or the child seems too tall for the maternal pelvis. However, the question of caesarean section or natural birth, according to health experts too often decided in favor of the surgical intervention. For many clinics in Germany, this seems to be a lucrative business.

Imperial cuts are being billed by the clinics more and more frequently as emergency operations, presumably for economic reasons. (Image: GordonGrand / fotolia.com)

Health insurance companies calculate caesarean sections more often than emergency surgery
As reported by the dpa news agency, hospitals in Germany are increasingly calculating their caesarean section births as expensive emergency surgery, but the cheaper planned interventions are less frequent. This is shown by an evaluation of routine data of the Techniker Krankenkasse (TK), which is available to the German Press Agency. According to that, from 2005 to 2008, unplanned and planned surgery for caesarean births would have kept the balance throughout. It is said that the scissors opened in 2009, just when it became known that hospitals could charge a higher price for an emergency caesarean section than for a planned caesarean section.

"Economic incentives seem to be crucial"
The ratio of unplanned to planned caesarean sections in 2014 was 56 to 44 percent. "The economic incentive seems to be crucial here," said Frank Verheyen, director of the Scientific Institute for Health Benefits and Efficiencies (WINEG). Currently, an average, unplanned caesarean birth with almost 3,400 euros to be billed, a comparable planned surgery, however, with just under 2,700 euros. According to the news agency, the statutory health insurance companies had uniformly remunerated a caesarean section before the new regulation.

High costs for the community of the insured
"In the course of our investigation, no other factors could be identified that account for the increase in unplanned caesarean sections," Verheyen said. It is said that the TK and thus ultimately the community of insured by the shift to more unplanned births on the operating table since the remuneration conversion additional costs in the amount of nearly 3.7 million euros have arisen. Extrapolated to the statutory health insurance, the additional expenditure for the period 2010 to 2014 amounts to 31.5 million euros.

Almost every third child comes by caesarean section
Since the turn of the millennium, the caesarean rate in Germany has risen rapidly and has meanwhile settled at a high level. Overall, according to the Federal Statistical Office in 2014, it was around 31.8 percent nationwide, compared to 21.5 percent in 2000. Also with the TK this trend shows itself. Accordingly, in previous years, more than 30 percent of all TK-insured newborns were delivered by caesarean section. The World Health Organization (WHO) recommends a Caesarean rate of no more than ten to fifteen percent. (Ad)