German clinics operating record-breaking

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Health minister sees false incentives for operations

In Germany there is too much and too quick an operation. The health insurance companies accuse German clinics of this. After the leading association of statutory health insurers (GKV) came to this result in a study last summer, Health Minister Daniel Bahr (FDP) is now sounding the alarm. The increasing number of inpatient hospital stays and surgical interventions is not solely due to demographic change and medical progress. The question had to be asked "whether there are also false incentives," said Bahr at the opening of a conference by his ministry with the Organization for Economic Cooperation and Development (OECD).

High costs and additional burdens for hospital staff due to increasing operations Minister of Health Bahr had invited to Berlin to investigate the cause of the rapidly increasing number of operations in German hospitals. The health insurance companies' accusation is clear: in Germany, too much and too much surgery is done at the expense of patients and contributors. The OECD presented a report on this subject with an international comparison.

Bahr pointed out that the increasing number of surgeries not only cause high costs, but also mean a significant additional burden for doctors and nursing staff. The health minister therefore wants to create incentives for hospitals in the future that are characterized by good treatment and do not "just operate".

There is more surgery in Germany than in almost any other country. In an international comparison, Germany is one of the top places when looking at the figures for operations and inpatient hospital stays. According to the OECD, 240 hospitalizations per 1,000 inhabitants were last registered. This is more than in almost any other country. Only Japan and Korea provide more than 8.3 hospital beds per 1,000 inhabitants for their population. According to the OECD, the number of cancer treatments in Germany is almost twice as high as the international average, although there are no more cancers in Germany than in other countries.

Last summer, the National Association of Statutory Health Insurance Funds presented an investigation together with the Rheinisch-Westfälisches Institut für Wirtschaftsforschung (RWI), according to which the number of treatments increased by 13 percent between 2006 and 2010. Only 40 percent of this can be attributed to the aging population, study author Boris Augurzky, health expert at RWI reported. GKV and RWI see the main reason for the steadily increasing number of treatments in the increasingly expensive operations. The hospitals would therefore increase the number of lucrative treatments. The increase in orthopedic and cardiological interventions is particularly drastic.

The vice chairman of the National Association of Statutory Health Insurance Funds, Johann-Magnus von Stackelberg, criticized patient treatment, which was largely controlled by the price. He pointed out that there are signs that operations are not always carried out for purely medical reasons, but also for economic reasons.

According to the head association, the false financial incentive for operations is also due to the bonuses that are customary in many chief physician contracts that are paid for certain interventions. Even the German Society for Surgery is in favor of pushing back such agreements from the chief physician contracts.

Unnecessary operations “on the verge of physical injury” Günter Wältermann, head of the AOK Rhineland / Hamburg head, finds clear words to the “world”: “In Germany people are operated on too quickly or even unnecessarily. That can be on the verge of bodily harm. ”In this connection, he also points out the bonus payments to chief physicians for multiple operations. "If the patients know about the quality differences, they vote with their feet." There are generally too many hospital beds, "the hospital sector has to be reduced," said Waltermnn. The CEO of AOK Rheinland / Hamburg advises patients to get a second opinion before going under the knife. In addition, those affected could seek advice from the health insurance company when choosing a hospital. (sb)

Also read:
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Unnecessary operations by professional clinicians

Image: Dieter Schütz /

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