Berlin (dpa) - For the intensive care of seriously ill people - for example with artificial ventilation - there are new quality requirements to ensure a high standard of care. This is the aim of a law by Health Minister Jens Spahn (CDU), which the Bundestag passed on Thursday evening (July 2).

“People in need of intensive care should be able to be cared for where it is best for them. That shouldn't be a question of the purse, »said Spahn. Therefore, binding quality requirements for intensive care at home would now be laid down. In addition, intensive care in inpatient facilities is “finally affordable”.

Intensive care can also be provided at home

The reform plans had been changed after protests by doctors, patient representatives and social organizations. The criticism was sparked above all by the fact that intensive care in your own home was originally supposed to be an exception. Compulsory hospitalization was often feared.

Instead, it is now planned that out-of-hospital intensive care can generally be provided in nursing and disabled homes, residential units and also “in one's own home”. "The legitimate wishes of the insured must be met," says the law. SPD faction vice Bärbel Bas emphasized: "If a person is well cared for at home, it will also be possible in the future." The opposition still has doubts about this.

According to the law, the medical services on behalf of the health insurance companies are to conduct annual on-site assessments to determine whether medical and nursing care is ensured. Only specially qualified doctors are allowed to prescribe intensive care outside the hospital. They can only take over quality-tested nursing services.

Relief of those in need of care from personal contributions

In order to prevent accommodation in a residential facility from failing due to money, people in need of intensive care should largely be relieved of their own expenses. Spahn also emphasized: "We oblige hospitals and homes to wean their patients from artificial ventilation if possible." A weaning attempt should be made before discharge from the hospital - clinics should also receive additional remuneration as an incentive.

The German Foundation for Patient Protection criticized that the law still interfered deeply with the rights of those affected. "Furthermore, the medical service has too much scope to decide whether the quality of care is good or bad," said board member Eugen Brysch. In order to prevent criminal structures and abuse in intensive care, a uniform patient number and priority public prosecutors are also required.

The law also provides facilities for rehabilitation if you want to select a specific facility for it. If it should be different from what the health insurer intended, only half of the additional costs will be covered - and not completely. Older people should be able to access rehabilitation measures more quickly and easily. If a doctor prescribes it, the health insurance fund no longer checks whether rehab is medically necessary when applying. In the case of geriatric rehabilitation, the maximum duration should also be declared as the standard duration - namely 20 days for outpatient treatment and three weeks for inpatient treatment.

© dpa-infocom, dpa: 200703-99-660093 / 2

Decision recommendation with changes