Abstracts by keywords: profitability
Small children's clinics in Mecklenburg-Western Pomerania are affected or threatened by closures, even though the number of chronically ill children, for example with diabetes, asthma and obesity, is increasing. One in six children now suffers from a chronic health disorder [1]. Both economic factors, such as problematic remuneration via the DRG system, as well as personnel factors influence the clinical operations of small children's hospitals. On a personnel level, the clinics compete with each other for assistants and specialists - but also in competition with a branch for specialists. In this competition, small departments, regardless of specialty, have a disadvantage in their attractiveness in that a much higher frequency of service by doctors is necessary to maintain care. In order to maintain a 24-hour service system, a high level of personnel is required. In the case of smaller departments, these maintenance costs are largely independent of how many planned beds they hold, as a base of qualified staff is necessary. If the number of cases increases while personnel costs remain the same, a better profit situation can be assumed [2]. Minimum staffing limits for medical staff equivalent to the minimum nursing staff limits only exist in the form of the “specialist standards” and in perinatal centers, the “cash cows” of inpatient pediatric and adolescent medicine, which are only available at large clinics.