AWMF discusses the design of the hospital reform

24.05.2023 18:36

As part of their delegate conference, experts from the Association of Scientific Medical Societies (AWMF) discussed how the planned hospital reform should be designed to ensure patient-oriented, scientifically sound and resource-conscious healthcare. The AWMF's ad hoc commission on care structures worked with 80 specialist societies to develop proposals for the design of the service groups, which the AWMF handed over to the Federal Ministry of Health. The specialist societies have defined requirements for performance groups and structures.

The specialist societies in the AWMF support the planned hospital reform with future remuneration in performance groups and a fixed share of maintenance costs. This is a key result of the AWMF's ad hoc commission on care structures, which, together with 80 member specialist societies, formulated requirements for the design of the reform. “The hospital reform is an important and necessary step to reduce the economic pressure on hospitals and to maintain high quality care even in times of increasing patient numbers and decreasing availability of skilled workers,” emphasizes Professor Dr. Rolf-Detlef Treede, President of the AWMF.

“Germany is one of the countries with the highest health spending and yet there are quality deficits, clinics that are fighting for financial survival and increasing supply bottlenecks due to a lack of staff. The aim of our reform recommendations was therefore to ensure long-term, comprehensive hospital care for the population using the available resources and to even increase the quality of treatment,” emphasizes Professor Dr. Tom Bschor, Government Commission Hospital Care Coordinator, who briefed delegates on the current proposals.

One of the key points of the reform is the definition of hospital care levels - from basic care at level 1 to maximum care at level 3. The majority of specialist societies rate the division of hospitals into three care levels as positive. However, there are still many open questions. In addition to suggestions for the performance groups, the participating member specialist societies have not only defined performance groups, but often also structural requirements. According to the ad hoc commission, patients should only be treated where the technical, personnel and quality requirements are met. “These performance groups can in turn be assigned to the different levels so that their demarcation is clearly defined,” explains Dr. Manfred Gogol, Chairman of the Ad-hoc Commission on Supply Structures. "We found that there must be additions to the drafts in North Rhine-Westphalia," Gogol continued.

According to the current proposals, the gastroenterology performance group, for example, is assigned to Level 2. Oncological liver or stomach interventions, on the other hand, should be carried out at level 3 clinics. “Since the hospital reform also provides for needs-based and quality-oriented reserve financing, the specialist societies have also defined the permanently necessary reserves for the individual service groups,” explains Gogol.

The ad hoc commission also developed a proposal on the open question of defining specialist clinics that focus on specific services. “It was important to the members of the commission to formulate quality requirements for the specialist clinics. They must meet above-average personnel and infrastructural criteria, such as equipment that also enables the care of rare and complex illness situations,” explains Dr. Monika Nothacker, co-chair of the AWMF ad hoc commission on supply structures. “It is now important to evaluate the possible effects of the changes in advance to ensure that the desired effects are achieved,” says Nothacker.

The commission continues to work on the evaluation of the hospital structural reform; the final overall results are still pending. “The AWMF and the scientific medical societies associated with it will continue to actively participate in the reform,” concluded AWMF President Treede.

The current publications and position paper of the Ad-hoc Commission for Health Services Research of the AWMF can be found here: https://www.awmf.org/medizinische-versorgung#c1845