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A curse for many clinics

Frankfurt More patients, more sales and maybe more earnings: The assumption that the clinics in Germany benefit economically from the spread of the coronavirus is “absolutely naive” in the opinion of Professor Jochen Werner, CEO and Medical Director of the University Medical Center Essen.

The opposite is the case, says Werner. He expects the corona virus to exacerbate the already difficult situation of hospitals in Germany. “There are fears that clinics will suffer massive economic losses up to bankruptcy due to the replacement of other medical services and offers without replacement,” says the clinic boss.

Because infectious patients always require a disproportionately large amount of care, starting with a separate admission, appropriately trained staff, specially equipped hospital rooms with locks and negative pressure, and a high consumption of protective clothing for treatment and care, explains Werner.

“If you imagine the case of a clinic, in which very suddenly financially adequate services cease in large numbers because infection patients have to be cared for, it quickly becomes clear that the coronavirus is not a money blessing for clinics, but rather a great economic danger.”

Thomas Lemke, CEO of the private clinic provider Sana Kliniken AG, also warns of possible negative consequences of the corona crisis for the clinics. Problems can arise when infected people come to the emergency room: “If an infection is now detected here, the clinics must also quarantine the staff.

At some point, there may be insufficient staff – also for the treatment of other patients. Operations have to be canceled. Then it can happen that clinics, which are already under financial pressure, get into a real imbalance, ”says Lemke.

The hospitals in Germany are prepared for the spread of the coronavirus, the German Hospital Society assures. More than 1400 internal departments and over 1200 intensive care units are available with approx. 28,000 intensive care beds ready to care for patients.

However, people who are concerned that they have contracted the virus should never go straight to the emergency room or to their family doctor. For this purpose, the local health authorities have set up special telephone numbers under which infected persons may receive further instructions and advice.

Nevertheless, the coronavirus will present the clinics with great challenges if the industry agrees. “A further spread of the coronavirus will tie up high resources in the form of (isolated) beds, staff or also intensive care unit capacities, with which a future limitation of the regular medical care, which cannot be estimated at the current time, can be expected”, says Werner of University Hospital Essen.

The clinics are also committed to the well-being and recovery of other patients: “Almost all, i.e. almost 100 percent of the patients currently treated in hospitals, do not suffer from the lung disease Covid-19, but from other, sometimes very serious diseases. Even if the coronavirus continued to spread, this group of patients would still be the largest by far, ”says the doctor.

The situation in the German hospital industry is not easy even without the impending spread of the coronavirus. The more than 1900 clinics have been groaning under increasing regulation and bureaucracy for years. As a result, the gap between costs and revenues continues to widen.

Expert Lauterbach causes outrage

According to the figures from the statutory health insurance company published last week, expenditure on hospital treatment rose last year by 3.9 percent to 80.9 billion euros. At the clinics, however, this growth does not automatically translate into growing profits, because personnel costs and material costs sometimes increase more sharply. In addition, the clinics have to finance more and more necessary investments from ongoing business.

For years, the federal states have not fulfilled their obligation to provide investments in buildings and medical technology to a sufficient extent, as the industry repeatedly complains about. Against this background, the hospital managers are worried about the additional economic burdens that could arise from the corona crisis.

The statement by SPD health expert Karl Lauterbach in a TV interview on Sunday evening caused outrage in the industry, according to which private hospitals might reject corona patients in order to keep more lucrative patients. “Given the current situation, referring to supposed economic reasons, as Mr. Lauterbach did, is perfidious and unacceptable. Because he accuses private operators of putting profits before human life, ”said Sana boss Lemke. “It is outrageous that a politician who should have known better is publicly expressing himself in this manipulative manner in the face of an already worsening crisis of confidence.”

The German Hospital Society also criticized the statement as completely irresponsible. “All hospitals, all employees in all clinics focus on the care of people, especially in times of need. And it goes without saying that hospitals, regardless of their sponsorship, will cut back on services that can be planned if it is necessary to care for corona patients, ”said Gerald Gass, President of the German Hospital Society.

“We are at the beginning of a corona epidemic”

However, the hospital company relies on political support: “We trust that the Federal Minister of Health will make all the necessary decisions, that the current situation will not lead to financial problems and bankruptcies in hospitals,” said President Gass.

In one respect, Minister of Health Jens Spahn has already reacted and, in view of the corona crisis, has temporarily suspended the so-called nursing staff lower limits in hospitals – a rule that clinics have criticized as bureaucratic. The regulation, which has been in force since 2019, sets clear requirements for various departments in the hospital and shows the maximum number of patients per caregiver that can be cared for during the day and at night.

In fact, according to a survey by the German Hospital Society among clinics, staffing in 80 percent of the cases did not improve at all or only slightly. For this, the costs for personnel planning in many companies have risen, as have the requirements for short-term flexibility of employees.

Lemke, CEO of Sana Kliniken, assesses the move by the Minister of Health positively: “This is a very important signal for the industry,” he says and adds: “It helps us extremely, because the rigid bureaucratic requirements hinder a sensible treatment process at the bed.”

The Sana boss, however, wishes that the lower care limits should not only be abolished temporarily, but in principle. “The regulation clearly misses the needs in health care. The people who work in the hospitals are no longer in the mood for the rampant rule and bureaucracy. ”

Uniklinikchef-Werner also believes it is inevitable that the proportion of administrative work for employees will be reduced.

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