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Reforming emergency care : First aid for emergency services

First aid for the Rescue. To stop over-crowding and long hours Waiting in hospitals, will the Minister of health, Jens Spahn structure the emergency care is now complete.

the CDU politician, has Provided for three things. The former emergency-room physician on-call service and emergency service at the telephone numbers 112 and 116, 117 are to be merged. In the clinics, there should be a single point of contact for all emergency patients, in which the urgency of the cases and their further management is decided. And the rescue services should be paid for by the funds in the future for applications that call for a Transport to the hospital can be dispensed with.

Stressful situations for Doctors and Nurses

The quality of a health system show especially in dealing with emergencies, said Spahn at the presentation of his reform plans on Tuesday in Berlin. Currently you have the Problem, that "too many patients" in the Rescue of the crowded hospitals. As a result, longer waiting would result should only always be times for those Affected, but also stressful situations for Doctors and nurses in the clinics.

in addition to the course this is a risk that truly urgent cases in the patient's crush is not detected, possibly the same, and too late would be treated.

In Berlin and Brandenburg, four out of five patients in the clinic

It had to be assumed "that a non-negligible part of patients, more could be done in a normal doctor's office," - said in Spahns vertices for the Reform. The Minister highlighted the very different use of the Rescue, depending on the Region. In Mecklenburg-Western Pomerania, for example, almost 60 per cent of all emergency patients by the medical on-call service would be treated. In Berlin and Brandenburg, however, it was only every Fifth. 80 percent would be there, preferably at night and on the weekends, in the clinics. And for the capital alone, the corresponding Rates would probably be even higher.

numerically, the Problem relates to not a few. 19 million emergencies will be handled per year in Germany. 2010 landed 53 percent of them for the first time at the outpatient readiness, 47 percent in the hospital. Five years later, it was exactly the opposite of how a statistic of the Council of experts for the assessment of the development in the health sector. Since then, the displacement in the Rescue of the increased hospitals.

Central points of contact for pre-sorting

are mandatory There, so Spahns prior plans, shall be furnished to the new integrated Emergency operations center (INZ) and operated jointly by the associations of sickness Fund doctors and the hospitals. The Minister wants to make such calls, there are some places, mandatory. They were designed to be "for all who are able to walk to emergency patients" and patients that have been referred from the emergency command center, according to its vertices. You could, however, "also be controlled directly from the rescue service". Existing on-call service and portal practices should be transferred "gradually complete in the INZ".

In the respective port of call is to decide whether the Patient must be treated immediately to stay further investigation in the clinic, to has or – in the less critical cases to a doctor's practice is referenced. In the ideal case, he gets for the outpatient treatment an appointment.

Well-trained staff needed

For such assignments, you need to be particularly well-trained staff, said Spahn – and this of course is also a liability of legal protection. Finally, it is not a question of "how to play so far only on absolute security", but those who need any quick help, is also the time to sort out.

Financed the new start-up will be earmarked in the budget extra – a basic fee and a fee per case. However, the money for the emergency supply should be expected from the previous budget, said Spahn. How much is the Whole cost, he left it open. So far, the emergency care suggest nationwide, with about one billion euros per year , it was said of his Ministry.

rescue service can, in the future, settle the score, even without hospital transport in the case of funds

the cost of The Reform are complicated to calculate, because in addition to the additional expense savings. This concerns in particular the ambulance service. So far, the principle was, that the funds for the rescue have to cover operations only if the patients are then brought to the hospital – with the result that such transportation is carried out because of better billing option far too often.

Such a link, the cost of acquisition is apportioned now, "not necessary to avoid hospital admissions," it says in Spahns vertices. The rescue service will henceforth "regulated as a separate medical power".

basic legislative changes necessary

What may sound in the Details of modest, is actually a huge feat of strength, of power, due to the participation of the countries of the basic law, Changes are needed. Therefore, it will not proceed with the implementation. Into force of the new regulations are designed to occur according to the Ministry of the beginning of 2020. For the implementation, the Parties would then, but still plenty of time.

"wait a bit longer, as that there is Chaos", the motto of the Minister. But the country quickly into the boat: this Wednesday Spahn wants to present its plans to the Federal - Länder working group for cross-sector supply.

cash doctors warn of too many sites.

The kassenärztliche bundesvereinigung (KBV) criticised the fact that the locations are to be determined for the designated emergency centres of the Federal States. "Since the countries do not have to pay, will you identify well-generous locations," said KBV head Andreas streets.

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Of the hospitals, however, there was praise. The problems of the ambulatory emergency care to be unsolved "for years" and presented to the clinics with a high human and financial burden, said the President of the German hospital society, Gerald Gass. Each year, approximately 11 million people were in the outpatient clinics of the hospitals, to get help. "Help you not get in established area, obviously." This reality must be put to any Reform.

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