Before the federal-state talks on the planned hospital reform, the Hessian Caritas Association warns of "wild cuts in the hospital landscape". Especially in metropolitan areas such as the Rhine-Main area, however, there are too many hospitals, said Professor Max Geraedts, Director of the Institute for Health Services Research and Clinical Epidemiology at the University of Marburg, in an interview with the F.A.Z. Federal Health Minister Karl Lauterbach (SPD) wants to discuss the reform plans with his state colleagues on Tuesday.

Barbara Schäder

Editor in the Rhein-Main-Zeitung.

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The project aims to concentrate complex treatments at specialised hospitals in order to improve quality. This was recommended by a commission of experts appointed by the Federal Ministry of Health in December.

According to an analysis published in February by the German Hospital Association (DKG), the implementation of the expert suggestions would mean that a good half of all cardiology patients could no longer be treated in their previous hospital. In urology it would be 47 percent and in neurology 39 percent.

The shortest route is not always the best

However, admission to a specialized facility can bring advantages even for patients in mortal danger, despite longer journeys. This is shown by a study by Geraedts' Marburg Institute using the example of stroke patients: "In Germany, more than 6000 deaths per year within the first year after a stroke could be avoided if all patients were immediately taken to a hospital that has a specialized department (stroke unit) – even if that means a slightly longer journey," says the doctor.

The reason: "If they end up in the first clinic and cannot be treated professionally, the transfer takes half an eternity." Ultimately, much more valuable time is lost than if the ambulance service had directly headed for a hospital with a stroke unit a little further away, Geraedts said. "This can be reached by helicopter practically anywhere in Germany within 40 minutes."

Exceptions for rural areas are possible

Now, this is no consolation, for example, for pregnant women who are not high-risk patients, but would like to have a maternity ward near them. However, Health Minister Lauterbach has already defused the original reform plans in this respect: obstetrics should continue to be offered at small hospitals in rural areas. Exceptions to the principle that hospitals of the lowest level of care (referred to as level) must do without more complex treatments: "Especially in rural regions, the countries should be able to plan more flexibly and be given the opportunity to offer service groups that are actually only allowed in Level II and III hospitals in smaller Level I hospitals," the Ministry of Health announced in March.