/alliance image
Berlin – The bill to reform emergency care was approved by the Federal Cabinet today. The regulatory package is primarily intended to ensure better patient management, but also to expand the range of care services and thus ease the burden on emergency services.
According to the Federal Ministry of Health (BMG) content for a reform of the emergency services is currently being developed – this should become part of the emergency reform in the parliamentary process.
The emergency reform is urgently needed and “overdue”, said Federal Health Minister Karl Lauterbach (SPD). The quality of emergency care currently varies greatly between regions and many emergency clinics are overcrowded. The connection between practices and hospitals is also not working. “All of this is being systematically addressed with an important law,” said Lauterbach.
The package of measures now adopted includes the already known content of the emergency care reform bill (Emergency Law), which has at times been harshly criticized. German medical journal reported. This also affects plans to oblige statutory health insurance associations (KVen) to consistently provide telemedical and outpatient care.
Mandatory participation of KVs in integrated emergency centers
Furthermore, in the future, the so-called KVen acute control centers will perform the previous tasks of the consultation service center in the area of acute case placement and will be networked with the rescue control centers in a “health control system” – including the mutual transfer of digital cases.
Mandatory participation of KVs and selected hospitals in integrated emergency centres (INZ) should also be implemented. INZ locations will be determined by the autonomous partners in the enlarged state committee, in accordance with specifications of the uniform national framework, such as accessibility and opportunities for cooperation.
Regarding the possible foundations for a reform of the rescue service, the BMG stated that the inclusion of the rescue service in the Social Security Code V (SGB V) was particularly important. In addition, the rescue service should also be digitally networked with the other emergency and intensive care actors using the telematics infrastructure (IT).
Unrealistic staffing requirements are of no use to anyone
Bavarian Health Minister Judith Gerlach (CSU) called on the federal government to make improvements to the reform. “It is important for regional states like Bavaria that the regulations of the emergency reform do not overburden the available staff. Staffing requirements that cannot be implemented do no one any good and would only further endanger outpatient care in the area.”
Furthermore, the planned connection of an emergency pharmacy to INZ creates unnecessary duplication of structures for the established emergency pharmacy service and should not be pursued, Gerlach said. The planned timelines for the implementation of the individual reform projects are only six months, “completely unrealistic and should be extended”.
about the subject
German medical journal printout
aerzteblatt.de
The federal presidents of the Association of General Practitioners, Nicola Buhlinger-Göpfarth and Markus Beier, said that no one in the health system disputes that emergency care urgently needs to be reformed. The current structure is doomed to failure.
However, with the project now approved by the cabinet, the federal government is making a mistake. “The plans may be well-intentioned, but they cannot be implemented in this way and must therefore be fundamentally adjusted in the parliamentary process,” they said.
The federal government promises patient care without saying where the specialist staff will come from, according to Buhlinger-Göpfarth and Beier. General practitioners’ practices “definitely cannot do without specialists”.
Furthermore, there is no need for new parallel structures – but rather for “selected, well-equipped and efficient offerings”. For example, greater control of care by family doctors could sustainably reduce the burden on emergency services.
Health insurers are positive
Stefanie Stoff-Ahnis, vice-chair of the National Association of Statutory Health Insurance Funds, however, welcomed the cabinet’s decision. The emergency law contains many of the right starting points for improving care. Elements such as the INZ as contact and control points, as well as an initial assessment process, are long overdue.
The National Association of Statutory Health Insurance Funds also supports the planned adjustments to the KV’s health insurance mandate in acute emergency care. However, the health insurance association also warns that any expansion of existing structures must be done with a sense of proportion and must not present the KV with insoluble staffing problems.
From the perspective of health insurers, the Federal Joint Committee (G-BA) be involved in determining structural specifications, etc. “As a self-governing institution, the Federal Joint Committee has the knowledge and experience to do this, which is why this task should be assigned to it,” Stoff-Ahnis emphasized.
Reduce the number of cooperation contracts
In order to reduce the impending bureaucratic burden, the envisaged cooperation agreements would also have to be significantly simplified. The current draft envisages hundreds of such agreements between hospital operators and KVs.
In addition, there would be an equally high number of cooperation agreements with emergency services and the creation of joint organisational committees. In addition to the enormous financial and personnel costs, there is also the risk that the supply landscape will become fragmented.
“The emergency reform that has long been called for by many stakeholders in the healthcare system will come a step closer with today’s cabinet decision,” explained Ulrike Elsner, CEO of the Association of Substitute Insurance Funds (vdek). However, a structural reform of the rescue service must also take place urgently; this is the only way to organise a consistent change in treatment pathways in emergency care;
The president of the federal association AOK, Carola Reimann, made a similar statement. It makes sense and is right that the traffic light wants to solve the problem of chronically overburdened emergency rooms in Germany. However, the reform should not be viewed in isolation from other reform laws. Above all, the hospital reform (KHVVG) is crucial to ensuring the success of outpatient treatment – the emergency department has not yet been sufficiently taken into account in the current draft.
“The announced addition, which renovates the rescue centers and also conceptually integrates them into the renovation, must now take place quickly,” said Reimann. © aha/aerzteblatt.de