德国医院护士短缺——利润造成的?

4open Pub Date : 2019-01-01 DOI:10.1051/FOPEN/2019007
B. Brücher, D. Deufert
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引用次数: 9

摘要

在德国,护理人员的短缺损害了公共医疗保健,这就解释了为什么这是日常政治和媒体议程上的问题。在德国,在22年期间,通过以下方式实现了显著节约:(1)医院病床减少了29.3%,节省了119 000张病床;(2)病人护理和治疗日减少了23%,节省了4310万病人日;(3)住院天数减少了39%,节省了4.7天。与此同时,接受治疗的患者病例平行增加了26.5%,增加了410万患者的负担。自2010年以来,随着出生率再次上升,治疗病例也将增加。与此同时,在1999年(325 539人)至2009年(324 337人)期间,护士总数的百分比下降(- 2.1%),医院注册护士的百分比下降(- 0.4%),预防和康复设施(+15.1%)和/或门诊护理设施(+41.1%)和/或养老院(+24.8%)雇用的护士和/或养老院工作的护士(+77.9%)也下降了。这种“利润”既危及病人的护理,也减损了人们加入护理职业的兴趣。这甚至可能是一种目光短浅的走钢丝行为,最终可能会危及患者护理质量,从而抵消“患者安全”的营销策略。也许医疗政治应该重新考虑这样一个事实,即随着人口老龄化、出生率和移民的增加,这些因素可能导致医院的病人数量增加,现在需要解决这些问题,以避免未来的危机。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
German nursing shortage in hospitals – Homemade by Profititis?
The shortage of nursing staff in Germany compromises public healthcare in deference to profits explaining why this is on the daily political and media agenda. In Germany, over a 22 year period, significant savings were achieved by decreases in: (1) hospital beds by −29.3% saving 119 000 beds, (2) patient care and treatment days by −23% saving 43.1 million patient days, and (3) length of hospital stay in days by −39% saving 4.7 days. This occurred together with the parallel increase of treated patient cases by +26.5% with an additional burden of 4.1 million patients. Since 2010, as birth rates increase again treatment cases will also increase. In parallel, the percentage of total nurses has decreased (−2.1%) as well as that of registered nurses in hospitals between 1999 (325 539) and 2009 (324 337) have decreased (−0.4%), in conjunction with nurses employed in preventive and rehabilitation facilities (+15.1%) and/or in outpatient care facilities (+41.1%) and/or nursing homes (+24.8%) and/or nurses working in retirement homes (+77.9%). This “profititis” endangers both patient care and detracts from people joining the nursing profession. It might even be a short-sighted tightrope act which, in the end, might counteract the marketing strategy of “patient safety” by risking quality of patient care. Maybe healthcare politics would be well-advised to re-think the fact that as the population gets older and as birth rates and immigration increases, these factors could result in increased patient caseloads in hospitals which need to be addressed now so as to avert a future crisis.
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