AOK report helps with the clinic selection
In a study, the health insurance company AOK examined the quality of knee, hip and gallbladder surgery in hospitals in the Rhineland. There were large qualitative differences.
Clear differences in the Rhineland According to a current AOK Rhineland / Hamburg hospital report, there is a clear difference in the quality of hospitals in the Rhineland. For the report, the health insurance company evaluated data on knee, hip and gall bladder operations and checked how often complications or even follow-up operations occurred within a year of the operation.
Over 40,000 surgical data evaluated Although the AOK has already carried out and published similar examinations in the past, there is no general trend for the better. Data from 43,500 operations in 143 hospitals between 2009 and 2011 were evaluated for the report. However, according to Matthias Mohrmann, board member of the AOK Rheinland / Hamburg, the range of medical quality in the Rhineland is large. For example, if there were no complications in the best hospitals after predictable hip joint operations, "the worst hospitals alone have additional complication rates of up to ten percent after discharge from the hospital."
Good handles when removing gallbladder There are many good clinics in the Rhineland for the removal of gallbladder. The AOK evaluated the results of 133 clinics in which at least 30 AOK members were operated. 23 of the clinics examined scored above average, for example the St. Vincent Hospital in Dinslaken, the Sana Clinic in Remscheid or the St. Josef Hospital in Hilden. 89 hospitals had an average performance and 21 had poor results.
Complication rate very different in clinics Of the 101 hospitals in which knee operations were carried out, 13 percent are above average and thus rank among the 20 percent of the best clinics in Germany. However, 21 percent underperformed. The differences become clear when one considers the complication rate, i.e. revision surgery or mortality. In the very good houses this was 57 percent lower than in the bad hospitals.
Different reasons for hip surgery The AOK differentiates between hip surgery after a broken bone and the timely insertion of an artificial hip joint, which is necessary due to wear and tear. The “Maria von den Aposteln” hospital in Mönchengladbach-Neuwerk is one of the top groups in both categories. The report concluded that hip surgery in the best clinics had 15 times fewer complications than the worse ones.
No hospital good in all areas There is no hospital that performs equally well in all areas. According to the AOK report, the St. Vinzenz Hospital in Düsseldorf is one of the best clinics in the country for hip fractures, but one of the worst for gallbladder removal due to gallstones and the insertion of an artificial knee joint due to wear. The situation is similar at the St. Willibrord Hospital in Emmerich-Rees, which is one of the best in the case of a hip fracture and the bottom in the other categories. The managing director of the hospital, Johannes Hütte, explained that the results did not match the internal quality controls. But you take it very seriously.
Criticism from clinic operators Hütte and other clinic operators criticize the methodology of the evaluation. At the moment, even clinics are suing the AOK hospital navigator in a model trial in which the evaluated accounting data is published. "The scientific method is non-transparent," said Hütte. The informative value of the analysis is also questioned at the St. Vinzenz Hospital in Düsseldorf. It is problematic if only the data of people insured with AOK are used. The AOK is calm and hopes for the new federal government. "It would be nice if the legislator clarified the legal basis even more," says Matthias Mohrmann. The AOK would also like to see closer cooperation with the good hospitals. Mohrmann comments: "That would be better for people and also economically more reasonable because there would be less costs for post-operations." (Ad)
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