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Emergency of care in children's hospitals - warn specialist societies
If a child has to be treated in hospital because of an illness, all parents want the best possible care and quick healing. However, according to a recent study, the supply situation in German children's hospitals appears to be at risk. "The necessary care needs for sick children can no longer be guaranteed," warns Dr. Florian Hoffmann, senior physician of the interdisciplinary child intensive care unit at Dr. von Haunerschen Children's Hospital of the Ludwig Maximilians University Munich (LMU).
In recent years, financial pressure has led to a steady reduction in pediatric care capacity, which is now paying off bitterly. A recent study by the University of Cologne has shown that "in many places, the care of children with acute and chronically seriously ill conditions is no longer guaranteed (is) and that the quality of treatment is decreasing, which even leads to serious patient risk." The results of the study were published in the German Medical Journal .
Fewer beds and fewer staff
Also because the children's departments at the clinics generally belong to the loss-making sections, while good money can be earned in other medical areas, there has been an increasing restructuring of the pediatric care landscape in recent decades - to the detriment of the affected children. "Clinics have fewer and fewer beds and fewer and fewer staff to treat critically ill children," emphasizes Dr. Hoffmann in a communication from the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) on the current study results.
Care for seriously ill children is often not guaranteed
Based on individual and group interviews with 50 employees from children's clinics or children's departments in the fields of pediatrics and pediatric surgery, the study was carried out, the result of which is terrifying. First, a pronounced increase in performance is described in almost all areas of pediatrics, accompanied by increased patient numbers, more complex clinical pictures and shorter stays. However, the necessary care for critically ill children is often not ensured, which can pose a direct risk to health. In connection with this, the respondents also describe significant ethical conflict situations.
Serious effects for affected children
"More and more children have to be redirected to clinics that are more than a hundred kilometers away from where they live"; criticizes Hoffmann. This is a tragedy for a region as medically well developed as Germany. The situation is particularly precarious in pediatric intensive care, where staff and bed shortages regularly lead to supply shortages with serious consequences for seriously ill or seriously injured children.
Dramatic situations in the clinics
“The bottlenecks are particularly dramatic in the winter half-year. Every day we are faced with the question of which children we cancel and which we take in, ”reports Hoffmann. He was terrified "of what we would have to do to the children and parents again." Politicians had to act urgently before the health of children was risked by the economization of the system. It is important to ensure that the children are provided with excellent care close to where they live. "The decision-makers in politics and in the clinic management are asked to give children the maximum amount of health care that they are entitled to," says Hoffmann.
Underfunding needs to be addressed
"In addition to the political will, we now also need a social discussion about what the treatment of children is worth to us," emphasizes the senior doctor. The current study had shown that without the comprehensive elimination of underfunding, the care of critically ill children and the performance and competitiveness of pediatrics in Germany would be at risk. There is more and more space in the intensive care units in the clinics and the children have to be transported to hospitals far away.
Competition with profitable sub-disciplines such as neonatology also plays a role in the poor supply situation. Because in order to fulfill the personnel key specified there, the personnel have been moved. Conflicts of interest arose between neighboring pediatric specializations, although the staff of these intensive care areas should complement each other competitively, the DIVI criticized.
Significant improvements required
According to Dr. We have been heading Hoffmann for years with an open eye to the problem "and can no longer guarantee the comprehensive coverage of critically ill or seriously injured children in one of the richest countries in the world." Significant improvements in training and working conditions are required, as well as that Payments for caregivers must be increased significantly. Overall, the increasing orientation towards economic goals in the field of medicine seems to promote considerable undesirable developments, which is particularly evident in the example of the children's clinics. However, comparable developments can also be observed in other areas of inpatient care and a rethinking seems urgently necessary here. (fp)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Geogr. Fabian Peters
- Weyersberg, Annic; Roth, Bernd; Köstler, Ursula; Woopen, Christiane: Pediatrics: caught between ethics and economics; in: Deutsches Ärzteblatt, vol. 116, issue 37, 2019, aerzteblatt.de
- German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI): Alarming study results: Doctors warn of a supply emergency in German children's hospitals (published 04.10.2019), DIVI