Thousands of patients die every year in German hospitals simply because their treatment does not meet the highest quality standards. The analysis presented by a government commission in Berlin on Thursday puts the number of preventable deaths from strokes alone at around 5,000 per year. Federal Health Minister Karl Lauterbach (SPD) sees the findings as confirmation of his plan to focus more on specialization in the clinical area.
“The hospital reform will save tens of thousands of lives a year,” said Lauterbach in Berlin. “Quality saves lives.” In the future, complicated interventions should “only be carried out in specialized clinics and by very well qualified doctors,” he said. “Not every house has to offer every medical treatment.”
The analysis comes to an alarming core finding: Thousands of people could still be alive if they had been treated in a better-equipped hospital. The head of the government commission, Tom Bschor, said the analysis shows “that in the current system, cancer and stroke patients are dying earlier than necessary because too many hospitals are performing these treatments”. Not every clinic is able to offer treatment at the highest level.
For stroke patients, for example, according to the study, it makes a clear difference which hospital they are admitted to: In clinics with a specialized stroke center (“stroke unit”), 23.9 percent of the patients died within one year after the stroke. In clinics without such a center it was 30.4 percent. Only about a quarter of German hospitals have such a “stroke unit”.
In addition to the area of stroke, the analysis focuses on the treatment of cancer. For example, breast cancer patients have an almost 25 percent higher survival advantage with initial treatment in a certified special hospital, according to the analysis. A survival benefit has also been demonstrated for other types of cancer, albeit to a lesser extent.
According to the Commission, a total of 20,404 years of life could be saved each year by cancer patients if treatment were to take place in certified facilities that meet the highest standards. This figure cannot be precisely converted into avoidable deaths, because some patients’ lives are only extended by a few months, others by many years, and others may be cured.
As a consequence of its findings, the commission points to an urgent need for reform: The current situation, in which clinics can often provide all services, leads to “quality deficits, increased morbidity and mortality, but also to comparatively high costs,” she writes.
Commission head Bschor recommended a “concentration of treatments in experienced clinics in order to offer comprehensive and close-meshed excellent care”. This is exactly one of the central points of Lauterbach’s reform plans for the hospital system, which he has been negotiating with the federal states for months.
Lauterbach wants to implement a fundamentally new financing system for the clinics, many of which are in the red. In order to improve medical quality, he relies on the specialization of the clinics – and in future wants to make the performance record of each individual clinic in the treatment of certain diseases publicly accessible.
Resistance comes from the countries. They fear, for example, the closure of many small hospitals that are important for rural care. The federal and state governments want to meet for another round of negotiations this month. Lauterbach aims to then work out a draft for the hospital reform over the summer break.
