Quality in hospitals varies greatly

Quality Report 2012 shows strengths and weaknesses in clinics

16/10/2013

Hospitals in most cases offer a good quality in terms of treatment and diagnoses. To this result is the „Quality Report 2012“ Every year, it is commissioned by the Joint Federal Committee of Clinics, Doctors and Health Insurance Funds of the Institute for Applied Quality Assurance and Research in Health Care (AQUA Institute). Despite the predominantly good reviews, there is still an urgent need for improvement in some clinics, according to the report.

Predominantly high treatment quality
According to the currently published „Quality Report 2012“ In German hospitals, there is predominantly a high standard with regard to treatment and diagnoses. Accordingly, would „The results show that the overall quality of treatment in hospitals is good and at a high level“ said Prof. Joachim Szecsenyi from the AQUA Institute at the 5th Quality Assurance Conference of the Joint Federal Committee on 14 and 15 October 2013 in Berlin.

Improvements to 57 quality indicators
For the current report, the AQUA Institute had evaluated a total of four million data sets from 1658 hospitals and was able to determine relatively high quality standards in most cases. The comparison with the previous year's results was particularly positive as, according to the Chairman of the Quality Assurance Subcommittee of the Joint Federal Committee, Dr. Ing. Regina Klakow-Franck, at 57 quality indicators improvements could be measured. This concerns for example the „Performance range pacemaker-unit change“ in which „a significant improvement in the duration of the pacemaker aggregate of bicameral systems can be measured“ could, like Dr. Regina Klakow-Franck explained in the foreword of the quality report. In addition, the decline in blood poisoning among newborns in the area is particularly pleasing „hospital infections“, on which the examiners had placed a special emphasis with their evaluations.

In some clinics yet „air upward“
Despite the pleasing results at first glance, the report also shows a different side, because in addition to the many positive test results, there are also clear outliers down: „If you take a close look at the figures, you will notice that there are areas and hospitals where there is still room for improvement in terms of quality. Not every hospital has met the quality expectations and it has to be worked on“, sums up Prof. Joachim Szecsenyi.

Guideline for cardiac surgery not always respected
This applies, for example, to interventions in restricted functioning aortic valves between the heart and the main artery, which can be carried out both by a traditional operation and by a newer procedure via catheters. However, due to the high burden of surgery, a guideline states that the newer method should only be used in elderly patients. According to the report, there were about 10,000 cases each of the two procedures in 2012, but the guideline was not always followed - instead, one-third of the catheter method had been used on younger patients.

Strong differences between individual hospitals
Overall, there were massive differences in quality between individual clinics. For example, "in many homes, certain cardiac examinations will only be performed as intended if clinical signs of coronary artery disease are actually present, but in others this is only the case for 20 percent of patients," Dr. Regina Klakow-Franck exemplifies.

GKV-Spitzenverband demands uniform documentation standards
From the point of view of the hospitals, the current report confirms the high quality standard in German hospitals, since „The AQUA Institute certifies that hospitals have good to very good quality of care in many areas of performance“ have. On the other hand there was criticism on the part of the GKV-Spitzenverband: According to the Head of Unit Quality Assurance Hans-Werner Pfeifer „The quality measurement will only work if all coverage areas collect the data on a comparable basis.“ However, there would still be considerable need for action in the outpatient sector: „We therefore demand uniform documentation standards for all areas of patient care“, Pfeifer continues. (No)