German hospital curtails services because of deficitBMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7379.11/a (Published 04 January 2003) Cite this as: BMJ 2003;326:11
For the first time in Germany a hospital has decided to halt all patient care for a period, apart from emergency services.
The university hospital at Greifswald, in the east German state of Mecklenburg-West Pomerania, announced in December that it was planning to stop all regular treatments until 31 December 2002, because the hospital budget could not cover them.
The budget, granted by the health insurance companies, is currently based on a lower number of cases than actually treated in the hospital. The limit was reached in November. For each of the 1400 extra cases, the insurance companies pay just 15% of the actual costs.
The hospital announced that it saw no other way to deal with the €2.7m (£1.7m; $2.8m) deficit and pointed out that further deficits will be expected in 2003, because by law the budget has to remain almost stable.
However, the hospital's medical director, Professor Andreas Greinacher, stressed that emergency treatment of patients was not threatened.
The health minister of Mecklenburg-West Pomerania, Marianne Linke, criticised the drastic action, because it might cause anxiety among patients, but she was prepared to discuss support that might solve the hospital problems.
The Marburger Bund (the largest hospital doctors' organisation) and the regional Mecklenburg-West Pomerania Hospital Society, which lobbies for hospital interests, praised the courage of the hospital officials in taking this action and highlighting the severe problems faced by most hospitals.
In the coming years it is expected that a number of hospital departments and hospitals will have to close because of insufficient funding by the health insurance companies.
The government has introduced a law that allows a maximum annual increase in budgets of 0.8%. However, hospitals have to deal with rising wages and drug prices and higher costs of medical equipment.
Doctors will get no budget increases and face possible reductions in overtime hours, and they are currently considering strike action and restricted services.
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