Rush in Emergency Rooms and On-Call Services: A Relentless Challenge in Thuringia's Healthcare System
Persistent Attack on Emergency Departments and On-Call Services Persists - Persistent influx to emergency department with waiting staff on alert
The torrent of patients flooding emergency rooms in Thuringia's hospitals and on-call services of general practitioners persist as a daunting predicament. As per clinic representatives, the shutdown of individual hospital locations and the scarcity of general practitioners are becoming increasingly predominant factors. According to the Association of Statutory Health Insurance Physicians, clinic emergency rooms and the association's on-call service process about half a million physician-patient interactions annually in the state.
After an appreciable dip during the COVID-19 pandemic, the level of 2019 has resurged. During that period, on-call services garnered the majority of attention. Now, the focus has shifted to clinic emergency rooms, often visited by patients during the operating hours of doctor's practices - the time when practices should ideally handle patients.
Patients without a general practitioner resort to on-call services
The causes behind this trend are multifold. In the opinion of the chairwoman of the association, Annette Rommel, it's simply habitual for many people to visit hospitals with complaints. In conformity with the Thuringian Hospital Act, clinics are prohibited from turning patients away. Gundula Werner, managing director of the Clinic of the Altenburger Land and chairwoman of the State Hospital Association, remarks that in rural regions, many people can't seem to find a general practitioner, which then compels them to head straight to the emergency room.
It also occurs that practice doctors recommend their patients to go to the emergency room. The validity of whether it's a genuine medical emergency every time is subject to debate. Werner: "From the patient's perspective, undeniably, but perhaps not always from the doctor's perspective."
"Now it's the case that patients simply can't find a doctor, self-assess as an urgent case, and then go to the emergency room," said Stephan Breidt, spokesperson for the Thuringia Clinics Saalfeld. Typically, the complaints are ailments that should be treated by general practitioners. In most cases, these aren't indications for inpatient admission.
Closure of hospitals burdens Saalfeld emergency room
According to Breidt, the situation in the Saalfeld emergency room has significantly deteriorated since the hospitals in Schleiz and Neuhaus am Rennweg were closed last year. Since then, the number of cases in the emergency room has doubled. "Previously, there were up to 80 cases a day, now there are 150," said Breidt. "That's no longer manageable."
The association also struggles with issues related to the statutory health insurance on-call service. Currently, about 115 general practitioner positions are vacant in Thuringia, which also implies a deficiency of doctors for the on-call service, which is sustained via around two dozen on-call service centers, transportation services, and even video consultations. The association is currently deliberating on the development of the on-call service.
From the viewpoint of the association and the State Hospital Association, a transformation of emergency care is urgently required. The previous governing coalition had already submitted a bill for this. According to the proposal, access points should be established in clinics to direct patients to the emergency room or an on-call practice based on the urgency.
Insights:
- Emergency department surges are a growing challenge in Thuringia due to hospital closures and insufficient access to general practitioners, leading to increased pressure on emergency services.
- Shortages of general practitioners exacerbate the issue by preventing proper management of patients in community settings.
- Expansion of home-based and community healthcare, integration of digital health services, strengthening primary care networks, and offering financial incentives for rural practice are proposed solutions to address the prevailing predicament.
Sources: [1], [5]
- The emergence of emergency department surges in Thuringia's hospitals is largely influenced by the closure of hospitals and insufficient access to vocational training for general practitioners, which has resulted in an increased burden on emergency services.
- To address the prevailing predicament of shortages in general practitioners, it is crucial to invest in community policy for the expansion of home-based and community healthcare, integration of digital health services, strengthening primary care networks, and offering financial incentives for vocational training in rural areas to encourage new practitioners.
