Zi statement on planned changes to acute and emergency care
26.05.2023 13:45
As part of the amendments to the Care Support and Relief Act (PUEG), the Bundestag Committee on Health also voted on an adjustment of the legal mandate to the Federal Joint Committee in accordance with Section 120 Paragraph 3b SGB V. The chairman of the board of the Central Institute for Statutory Health Insurance (Zi), Dr. Dominik von Stillfried:
“Unfortunately, the Health Committee has, to a large extent, surprisingly created facts that make progress in improving acute and emergency care for 73 million citizens in Germany difficult. If the Bundestag approves the law on May 26th, as expected, the political goal of improved patient management in emergency care to relieve the burden on emergency rooms will initially be significantly weakened.
We remember: The Federal Joint Committee (G-BA) was commissioned at the time to decide on specifications for the initial assessment and, if necessary, referral of patients without immediate need for treatment to statutory health care by June 30, 2023. Shortly before the G-BA's expected decision, the legal basis for this will be changed significantly: In the future, the directive will no longer be able to regulate the forwarding of those seeking help requiring contract medical treatment to contract doctor's practices or medical care centers (MVZ).
The desired relief of emergency rooms is becoming a distant prospect
The initial assessment guideline therefore only has effect for the period in which a KV emergency service practice is staffed at the respective location. So far no guidelines have been needed for this. Rather, the actual task was to create a legally secure way to forward those seeking help who present to emergency rooms during the day during general practice opening hours with less urgent concerns that can be treated in a practice. The intended relief of the emergency rooms is now a long way off. The transfer to an MVZ at the hospital would also no longer be necessary.
Whatever one may judge the possible successes of the pending emergency reform, one thing is already certain: the government coalition has thrown the baby out with the bathwater with the sudden changes to Section 120 Paragraph 3b SGB V. Many collaborations that were created with the prospect of improved patient management between hospitals and statutory health insurance associations now have to deal with the fact that even the option of legally secure forwarding has been cut off for the time being.
Mismanagement is perpetuated
Actually, the management of the large emergency rooms should speak out critically on an ad hoc basis. From a contract medical perspective, it is to be complained that this perpetuates a mismanagement, the solution to which will in future be to rely on the working hours of practicing doctors as a resource instead of enabling resource-saving solutions. This actually no longer fits into a healthcare system that is likely to suffer from massive staff shortages in all areas. This completely reduces a forward-looking and sustainable health policy to absurdity!”