Abstracts by key term: hospital
Hospitals in Germany are often accused of over-provision and inadequate care due to unnecessary services and redundant locations. Drivers of this assumption are issues such as outpatient care and centralization. However, under-provision, which can result not only from a lack of capacity but also from a lack of competition between locations, is rarely considered. Competition for the best outcomes, however, would be a strong driver of high-quality healthcare. Data from the Federal Hospital Atlas were used to examine competition for typical treatment needs, the possibility of escalating emergency levels, and regional alternatives for special needs. For this purpose, a radius of 20, 30, and 50 kilometers was created around each location. For almost 30% of all treatment needs, a location lacked a competitor. This revealed strong regional differences between densely populated regions such as Berlin, Hamburg, and North Rhine-Westphalia, with almost consistent competition, and eastern, remote states, with a predominance of locations without alternative providers. An escalation of the emergency level would have been possible for more than 90% (from 1 to 2 or 3) or almost 80% (from 2 to 3) of the locations, provided the treatment situation had required it. Co-provision by neighboring states was particularly relevant for emergencies in Rhineland-Palatinate and Schleswig-Holstein (with escalation from 2 to 3). Alternative locations for certified facilities were predominantly found. However, the proportion of locations without competition in oncology depended heavily on the entity, being low for breast and colorectal cancer and high for stomach and bladder cancer. Overall, the results show that in Germany, neither regional aspects nor treatment reasons are equivalent living conditions in healthcare, especially when considering competition for quality. The discussion on eliminating potential over-provision and misprovision of inpatient services must therefore urgently be supplemented by the aspect of building additional capacity to compensate for undersupply.
04.08.2025
Previous studies have reported increased in-hospital mortality in patients with dementia (PwD), but findings across age groups, clinical departments, and admission diagnoses have been limited. The aim of this study is to compare in-hospital mortality in PwD across age groups, clinical departments, and admission diagnoses with that of control subjects without dementia.
03.12.2024
Interview with Andrea Schmidt-Rumposch, Director of Nursing and Board Member of Essen University Hospital
01.10.2024
Differences by facility type and relationship with work ability and burnout risk
01.10.2024
Interview with Prof. Dr. Jochen A. Werner, Medical Director and Chairman of the Board of Directors of Essen University Hospital.
01.10.2024
Scientific evaluation of a selective contractual cooperation model between a physician's office and a health insurance company. Patient support has been developed by Bosch BKK since 2005. Since 2007, it has been part of contracts with regional physician associations under Sections 73 and 140 of the German Social Code (SGB V). The purpose of these contracts is to provide intensive and holistic care for patients with high morbidity, as well as support […]
23.09.2012
The aim of the study was to analyze DRG-attributable effects on the care process in and around the hospital. On the basis of 30 representatively selected hospitals in Lower Saxony and using a differentiated methodology, it was possible to show: 1. The quality of direct patient care in the hospital has largely not changed due to the introduction of the DRG. 2. There is no evidence for a targeted selection of lucrative treatment cases. 3. The phenomenon of a "bloody dismissal" cannot be proven. 4. An increase in unplanned readmissions ("revolving door effect") in the course of the introduction of the DRG cannot be proven. 5. The hospitals have created the essential prerequisites for the operational implementation of the DRG system; a future-oriented strategic alignment and a consistent process design has only been partially implemented. 6. The working conditions have changed in the course of the introduction of the DRG, with the documentation and coding effort being overestimated. 7. The medium-sized and large hospitals are largely economically successful even under DRG conditions because they can use the opportunities for strategic realignment, while this is much more difficult for the smaller hospitals.