Are VA hospitals publicly funded
Figure 2 Personnel load figures by provider per day: Since it is based on the daily load or the number of patients to be cared for, this point of view points to a potentially better care for the patient as a result. However, it must be taken into account that these are average values and nothing has been said about compensation options in the event of an increased number of patients or staff absenteeism. But even those should be better with a higher personnel key.
It also shows that the non-profit organizations perform better than the private organizations in this approach, with care roughly halfway between public and private organizations. In the medical and medical-technical service, too, they do better than the private ones, albeit at a smaller distance.
The difference between the public and private bodies is enormous. In 2016, the private care providers had to care for 19.6 percent more patients per day on average, 29.4 percent in the medical service and 70.8 percent in the medical-technical service.
What does the difference in 2016 of 5.6 patients / day and nurse (under public law) and 6.7 patients (private) mean for the patients? Better care and more security. A study in California of 232 hospitals and 124,204 patients with 20 surgical DRGs showed a 9.5 percent reduction in the risk of pneumonia with a 10 percent increase in the number of nurses.
An examination of the data of more than 420,000 patients aged at least 50 years who had undergone surgical interventions in approx. 300 hospitals in New European countries (approx. 50 percent on the musculoskeletal system) showed: With every additional patient, the had a nurse to care for, the likelihood of a surgical patient dying within 30 days of admission increased by 7 percent. (Deutsches Ärzteblatt 2014, 111 (26)).
Differences in the public service providers
A distinction is made here between public hospitals in the form of public law, either as independent (e.g. special purpose association, establishment, foundation) or legally dependent (e.g. management or self-employed) and in private law form, e.g. GmbH.
The picture is inconsistent depending on the legal form. In the private-law form, the economic temptations at the expense of the quality of working conditions and patient care are obviously significantly higher than in the public-law form, but still lower than with the non-profit and above all also with the private providers.
Even if the personnel key is better with the public service operators than with the non-profit and not yet as catastrophic as with private carriers: There is no reason to be satisfied with it, on the contrary. In disputes that have been going on for years under the leadership of ver.di, it has finally been possible to force politicians to act. Even if the suggestions are far from being sufficient, a start has been made. The nursing emergency is the topic of the day, in several clinics collective agreements have been enforced to relieve the burden. In many companies, the staff has recognized: It is worthwhile to collectively defend yourself against overload. In several federal states, referendums against the nursing emergency have now been launched. Now the other professional groups have to become active. It is time to put a stop to private addiction to profit, for better working conditions for employees and better care for patients in hospitals!
Rudi Schwab is active in the ver.di Federal Expert Commission for Doctors and in the Association of Democratic Doctors (vdää). The article was published for the first time in the vdää magazine “Health Needs Politics”.
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