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Children's Hospital: A children's hospital that does not pay


Seriously ill children come to St. Augustin because the clinic specializes. But it has hardly a future, because the big centers are particularly promoted.

Since November 2014 is nothing more for family baths as it was. Doctors diagnosed medulloblastoma in the then three-year-old daughter Dorothea. The malignant tumor was in the cerebellum, he had to be removed. The girl was operated on, irradiated and treated with chemotherapy in several stages. The cancer disappeared. But in October 2018 he reappeared.

Since then, Dorothea has been hospitalized again. She gets a long-term chemotherapy, the Children's Hospital in St. Augustin near Bonn has become a second home for her - as for many other seriously ill children. "The people here sacrifice themselves," says Mother Corina. "Whether cleaning force or head physician, here all have the same goal: they want that patients and parents feel comfortable."

This could soon be over. In early July, the wearer, the Hamburg Asklepios Clinic Group announced that the renown Children's Heart Center should be closed. However, this jeopardizes the existence of the entire children's hospital. Asklepios explains the decision by saying that two leading cardiologists have left the hospital. The two were wooed by the University of Bonn, which is only about 20 kilometers away for several years, a kind of high-tech hospital city builds; including children's clinic and children's heart center.

The example of the St. Augustine Children's Hospital is representative of a dispute that has long since plagued health policy in Germany: how many hospitals does the country need? Is it crucial that every place of residence has a clinic within reach, is it even the duty of the public sector to provide basic services in the immediate vicinity? Or is it time to merge several houses into large clinic centers, which - according to the proponents' argument - could possibly offer better or at least less expensive care?

Too many clinics, too few subsidies

Patients in Germany could live on less than half of the existing hospitals. This had prompted the study on future-proof hospital care in July (see box below). The quality of care would be better, wrote the authors, especially in acute cases such as heart attack or stroke.

The criticism was great. The study propagated "the destruction of social infrastructure in an almost adventurous extent," said Gerald Gaß, President of the German Hospital Association (DKG). The President of the Chamber of Medicine Klaus Reinhardt called the paper questionable and referred to a commission set up by the Federal Government, which had "just recently emphasized the importance of providing services of general interest and securing an easily accessible health infrastructure".

Carriers like the Asklepios Group, however, were confirmed. In any case, they have been calling for many years to reshape the hospital market. Their position: Because there are so many clinics, the scarce state subsidies would be wrongly distributed. As a result, it comes to "significant inefficiency in the care and misallocation," Asklepios CEO Kai Hankeln said on request. In fact, the financial situation of many hospitals in Germany is precarious. According to the latest figures of the DKG, in 2017 every third clinic was in the red. But instead of courageously and systematically merging hospitals and closing departments or entire locations, Hankeln criticizes, "under the pretext of competition and quality orientation ... the unwanted houses would be sorted out on the carrier's image costs, as is currently happening in Sankt Augustin".

Source: zeit

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