Quality in hospitals fluctuates widely

Quality in hospitals fluctuates widely

Quality Report 2012 shows strengths and weaknesses in clinics

In most cases, hospitals in Germany offer good quality in terms of treatment and diagnoses. This is the result of the "Quality Report 2012", which is prepared every year on behalf of the Federal Joint Committee of Clinics, Doctors and Health Insurance Funds by the Institute for Applied Quality Promotion and Research in Health Care (AQUA Institute). Despite the predominantly good ratings, according to the report, there is still an urgent need for improvement in some clinics.

Mainly high quality of treatment According to the recently published "Quality Report 2012", German hospitals predominantly have a high standard with regard to treatment and diagnoses. According to this, "the results would show that the overall quality of treatment in the hospitals is good and at a high level", said Prof. Joachim Szecsenyi from the AQUA Institute at the 5th quality assurance conference of the Federal Joint Committee on October 14 and 15, 2013 in Berlin.

Improvements in 57 quality indicators For the current report, the AQUA Institute had evaluated a total of four million data records from 1658 hospitals and was able to determine relatively high quality standards in most cases. The comparison with the results of the previous year was particularly positive because, according to the chairman of the quality assurance subcommittee of the Federal Joint Committee, Dr. Regina Klakow-Franck, improvements could be measured with 57 quality indicators. This applies, for example, to the "Pacemaker unit change performance range" in which "a significant improvement in the running time of the pacemaker unit of two-chamber systems could be measured", as Dr. Regina Klakow-Franck explained in the preface to the quality report. The decrease in blood poisoning among newborns in the area of ​​"clinical infections", on which the examiners had placed a special focus in their evaluations, was also particularly pleasing.

In some clinics still "room for improvement" Despite the results, which are pleasing at first glance, the report also shows another side, because in addition to the many positive test results, there are also significant outliers downwards: "If you look closely at the numbers , one realizes that there are areas and hospitals where there is still room for improvement in terms of quality. Not every hospital has met the quality expectations and work needs to be done on this, ”summarizes Prof. Joachim Szecsenyi.

Guideline for cardiac surgery not always complied with. This applies, for example, to interventions with restricted functioning aortic valves between the heart and main artery, which can be carried out both by traditional surgery and by a newer method using catheters. However, due to the high burden of surgery, one guideline specifies that the newer method should only be used in older patients. According to the report, there were about 10,000 cases with the two procedures in 2012, but the guideline had not always been followed - instead, one third of the catheter method had also been used in younger patients.

Strong differences between individual hospitals All in all, there would be massive quality differences between individual clinics. "In many houses, certain cardiac examinations, as planned, would only be carried out if there were actually clinical signs of a coronary artery narrowing. In other houses, however, this was only the case for 20 percent of patients," Dr. Regina Klakow-Franck as an example.

GKV umbrella association calls for uniform documentation standards From the point of view of the hospitals, the current report confirms the high quality standard in German clinics, since "the AQUA Institute has certified that hospitals have good to very good quality of care in many service areas". However, there was criticism on the part of the GKV umbrella association: According to the head of the quality assurance unit, Hans-Werner Pfeifer, "the quality measurement can only work if all supply areas collect the data on a comparable basis." However, there would still be considerable need for action in the outpatient sector: "We therefore demand uniform documentation standards for all areas of patient care," continues Pfeifer. (No)

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