Too many patients use the emergency care for trifles

Analysis shows current state of German emergency rooms

A recent analysis, commissioned by the National Association of Statutory Health Insurance Physicians (KBV), found that hospitals increasingly have patients who are not objectively emergency-related. According to the analysis, this trend has a huge impact on the healthcare system. The result: Less time and attention to real emergencies, congested hospital staff and avoidable additional costs.

The Leibniz Institute for Economic Order (RWI) analyzed this topic for the KBV. The apparent trend shows that more and more people use the emergency room as an alternative to the doctor's visit. Some of the patients consider themselves to be in need of an emergency, others do not fit a doctor's visit into the appointment calendar, or the next free appointment with the specialist is only in three months. The full report "Emergency Care in Germany" can be found on the website of KBV.

Many emergency department patients are not considered an emergency by experts. This could be checked in the future by a general practitioner or by phone. (Image: schulzfoto / fotolia.com)

Why wait for a doctor's appointment if there is emergency room?

"The results of the investigation make it clear that a reform of the emergency care in Germany is urgently needed," reports Professor Dr. med. Andreas Beivers, health economist at the University of Fresenius, who contributed to the analysis. A central problem that clarified the analysis was the lack of patient control.

Lack of control mechanisms

According to Beivers, there is a lack of control mechanisms that, ideally, patients should assess before arriving at the emergency department. This will ensure the right supply. "Several neighboring countries have implemented reforms in recent years, among others with the aim of reducing the number of inadequate emergency department visits," said Beivers. For example, Denmark has been expanding patient control for some years and has also established telephone counseling services.

Example Denmark

Since 2014, patients in Denmark have limited access to emergency centers. Patients who want to visit an emergency room autonomously require a referral from a general practitioner or a registration via the emergency call. "If they do not take this into account, there can be considerable additional payments," explains Beivers. He suggests a similar model in Germany.

Medical telephone service 116117

Furthermore, Beivers proposes to increase the name recognition of the number 116117. This telephone on-call medical service can also provide medical assistance during the night, on weekends and on public holidays, and assess whether it really is an emergency. The telephone number 116117 works without area code and is valid throughout Germany. The call is free for both landline phones and cell phones.

Every second emergency room is superfluous in principle

The KBV reports that 736 emergency rooms are needed to provide 99.6 percent of all residents in Germany within a radius of a maximum of 30 minutes driving time. Currently, however, a total of 1,456 hospitals participate in emergency care. "That does not make sense in terms of supply technology or in terms of a sensible use of resources," comments Dr. med. Andreas Gassen, CEO of KBV in a press release on the analysis.

Subjective need for action is not the same as emergency

"The citizens are looking for their way into the care system and go to the emergency room, even if it is not necessary," adds the deputy chairman of the KBV. Stephan Hofmeister added. This happens both out of ignorance and out of a comfort attitude. In many cases, it is merely a subjectively felt urgent need for treatment.

Better information offer

"That's why we need to expand the range of information on the various levels of care and enable the citizens with the help of multimedia offers to pick the right one-stop shop," says Hofmeister. He also recommends a telephone initial consultation to assess the plight. (Vb)