[Staffing situation and basics requirement calculations in the inpatient and outpatient sector in Germany - a representative survey by the Working Group of Senior Gastroenterology Hospital Physicians (ALGK)].

Abstract

In Germany, there are no uniform hospital standards for the transparent calculation of medical staffing requirements in hospitals. This is particularly true for outpatient services.The ALGK conducted a member survey via the link https://de.surveymonkey.com/r/H7TTJYZ from March 21 to May 1, 2024. 400 members with a valid email address were contacted. The 119 extraordinary members who had ended their professional activity were not included. 17 questions were asked in the survey.The response rate was 24%. 37% represented basic and standard, 47% specialized and 16% maximum care providers. Municipal hospitals were represented by 42%, denominational providers by 34% and private providers by 24%. 7% of the hospitals had fewer than 200 beds, 28% 200 to 400 beds, 37% 400 to 600 beds, 15% 600 to 800 beds and 13% more than 800 beds. Up to 1.500 patients were treated annually in 15%, up to 2.500 patients in 15%, each up to 3.000 or 4.000 patient in 22%s, up to 5,000 patientsin 16% and more than 5.000 patients per year in 12%. The average casemix was 2373 ± 999 and the casemix index 0.70 ± 0.11. On average, 17.6 ± 7.6 doctor's posts were available and one consultant treated 14 ± 2.7 patients per day. A transparent personnel calculation was not available in 56% of the departments or clinics, in 82% there was no internal cost allocation or cost recovery calculation, in 54% there was no internal cost allocation. In 54%, there was no feedback on outpatient services from the administration, in 93% there was no transparent calculation of physician positions based on outpatient services, in 97% the training and further training of young colleagues was not taken into account in the calculation of positions, in 75% there was no communicated and recognizable strategic plan by the hospital operator for the senior gastroenterologists with regard to outpatient services. 49% of those surveyed feared that their hospital operator would not be able to cope with the restructuring in the healthcare sector with outpatient services, centralization, minimum volume compliance and would even jeopardize its existence.Transparent job calculation and communication about inpatient and outpatient gastroenterology services and the strategic objectives of the healthcare structural reform are very patchy in German hospitals. This leads to a high degree of uncertainty and existential fears.