Children's hospitals are off – Switzerland: Standard

In Zurich, Basel and St. Gallen, children's hospitals are not located under the roof of a university or central hospital for adult medicine. These are independent hospitals with a high degree of specialization. Every third child treated has a rare disease. However, specialization in serious illnesses in children makes hospitals increasingly in financial difficulty. The care of these children takes a lot of time, but will be paid insufficiently on rates, criticize children's hospitals. In addition, they usually deal with complex cases. Unlike hospitals with drugs for adults and children, there is no birth of healthy children in children's hospitals.

However, because serious cases are rare, the lump sums introduced in 2012 do not do justice to the costs of children's hospitals, complains about their alliance of all children. This refers to a corresponding study of 2017 by Swiss-DRG, the institution responsible for the tariff structure.

7 million losses in Zurich

The financial situation is exacerbated by the intervention of the Federal Council in the Tarmé medical outpatient tariff in 2018. Among other things, the length of speech of the patient was limited to 20 minutes, except for children under 6 years. However, in children's hospitals, 88% of conversations with children and parents lasted more than 20 minutes, says Manfred Manser, president of the Basel University Children's Hospital. Two in five children need more than 30 minutes.

The deficit of three outpatient children's hospitals is expected to increase from 21 million to over 30 million due to tariff intervention, Manser warns. The costs are covered only 65 to 70%. The Basel Children's Hospital alone was worth another 4.5 million this year. The Children's Hospital of Zurich plans a loss of 7 million Swiss francs for outpatient care, 2 million more than in 2017. Up to now, the canton has taken care of this deficit . But the Health Department of Zurich plans to abolish these contributions in the coming years. In addition, the hospital discovered costs for continuing medical education of 2.5 million. Although the children's hospital has a considerable endowment wealth and generates in the hospitalization area through private insured children and a foreign self-payer taxpayer. In the long run, however, a deficit of about 10 million can not be absorbed, says Michael Meier, Financial Director of Spital

Insufficient Legal Basis

Although in the three hospitals for children 95% of patients Outpatient treatment generates only 30% of their income. The rest comes from 18,000 hospitalized patients, including many children with congenital malformations. However, pediatric hospitals have also not received compensatory allowances in the area of ​​hospitalization for disability insurance and health insurance, says Manser. This is partly explained by the inadequacy of the legal basis for the compensation of IV. The Federal Council has promised an improvement with the current revision of the IV. Manser fears, however, with the proposal of the Federal Council, a further change in the funding of IV services to hospitals and cantons. According to Manser, it will become more and more difficult to ask the cantons to pay for the rise in hospital deficits.

Due to the difficult situation of child and adolescent medicine, a delegation of children's hospitals was presented to the Federal Office of Public Health (FOPH) in May. According to Manser, the BAG showed at least an understanding and willingness to discuss corrections in August when half-yearly figures were available.

Large deficits also in Berne

Agnes Genewein, general director of the children's alliance of the children's hospital, fears that hospitals can not maintain their level high quality in the long run. In the end, the children would suffer from a loss of quality, she warns in an article of "Ärztezeitung".

Children's clinics attached to the university hospital, as in Berne, must also fight. Children's hospitals of the island group made a loss of 13 million francs in 2017 in the outpatient area. The intervention rate of the Federal Council is expected to increase the loss by 1 million this year. The deficit of children's hospitals is to the detriment of the entire hospital group.

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Date created: 26.07.2018, 22:15