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CC BY-NC-ND 4.0 · Neurology International Open 2017; 1(02): E107-E116
DOI: 10.1055/s-0043-107628
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Structure of Neurological Departments in Germany: Results of the 12th Survey by the German Neurological Society

Michael Schroeter
1   Department of Neurology, University of Cologne, Cologne, Germany
,
Frank Erbguth
2   Klinik für Neurologie, Klinikum Nürnberg
,
Reinhard Kiefer
3   Neurologische Klinik, Agaplesion Diakonieklinikum Rotenburg gGmbH, Rotenburg/W.
,
Tobias Neumann-Haefelin
4   Neurologische Klinik, Klinikum Fulda
,
Christoph Redecker
5   Neurologische Klinik, Klinikum Lippe-Lemgo
,
Helmuth H. Steinmetz
6   Neurologische Klinik, Johann Wolfgang von Goethe Universität Frankfurt
,
Rainer Riedel
7   Institut für Medizinökonomie und Medizinische Versorgungsforschung, Rheinische Fachhochschule Köln
,
GereonR. Fink
1   Department of Neurology, University of Cologne, Cologne, Germany
,
On behalf of the committee „Benchmarking & Quality Management“, German Neurological Society (Deutsche Gesellschaft für Neurologie) › Author Affiliations
Further Information

Publication History

Publication Date:
21 June 2017 (online)

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Abstract

The German Neurological Society has conducted a survey of the structure of neurological in-patient care every other year. The present survey covers the year 2015. With a response rate of 62% in mind, the questionnaire allowed meaningful comparisons to former surveys covering the years 2013 and 2011.

Only a minority of departments maintains intensive care units of their own. In contrast, 24/7 presence of neurological physicians has become standard in interdisciplinary emergency rooms. Stroke management has made neurology increasingly involved in emergency care. Since 2015, thrombectomy has been recognized as state-of-the-art therapy for a subgroup of stroke patients, raising special demands for the availability of CT and MRI on a 24/7 basis. However, infrastructure did not improve as compared to former surveys.

Number of beds, total procedures and average procedures per case proceeds (case mix, case mix index) has remained roughly unchanged. However, case numbers increased, and average length of stay robustly decreased within 2 years by 17% to 5.4 days.

Staff structures were heterogeneous and were involved in various duties apart from inpatient care covered by the German Diagnosis-Related Groups (DRG) system. Departments did not succeed in differentiating expenditures related to the DRG system from other procedures. Shortage of nursing staff forced 22% of departments to temporally reduce services, 6% of departments did so because of a shortage of physicians, and in 2% of departments, both occurred. Departments were confident of certifications as means of quality management, and a few suggestions were provided for more meaningful parameters for outcome-oriented quality management in the future.

Key words

infrastructure - German diagnosis related groups - human resources
 

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