The logic is obvious: The more complex operations at a clinic, the more experienced the staff is and the less it comes to complications or even death in some cases. In Germany, minimum quantities apply, therefore, for the past 15 years for certain predictable and complicated procedures. But according to a recent study, 40 percent of clinics that perform these treatments ignore the numbers prescribed by law case. Sanctions there are, as yet, no.

For the analysis of the Science Media centre and the project evaluated a “White list” of the Bertelsmann Foundation, the quality reports of the hospitals for the year 2017. Accordingly, the 458 made of 1152 clinics complex operations without the legally prescribed minimum observed number. This would correspond to nationwide, around 4300 operations. In addition, a quarter of the analyzed hospitals was incomplete quality reports.

Specifically, it is:

• Organ transplants (at least 20 liver and 25 renal transplants per year)

• Certain operations on the esophagus, the pancreas (a minimum of ten per year)

• Stem cell transplants (a minimum of 25 per year)

• Knee joint prostheses (at least 50 per year)

• Care of premature babies with a birth weight less than 1250 grams (a minimum of 14 per year)

While there are regional differences according to the provinces, and also in accordance with the procedures in question: While in Mecklenburg-Vorpommern 29.2 percent and in Baden-Württemberg , which is 30.7 percent of the clinics one or more of the minimum figures not be reached, in Brandenburg, 56.7 per cent, and in Bremen, even 62.5 percent.

In operations on the pancreas, 66 percent of hospitals met the minimum number of operations, in the case of esophagus-OPs, there were just under 48 percent. “The fact that in Germany the complicated OPs are carried out despite the lack of Routine, may not belong to the clinical routine,” said Brigitte Mohn to the Board of Directors of the Bertelsmann Foundation.

Hospitals reject allegations

The researchers call for, to control the compliance with the minimum amounts, and to impose necessary sanctions. In addition, keep the current requirements for to lax. In England and Finland, the case would pay up to ten times higher, and would often apply per doctor and not per clinic.

The German hospital company rejected the allegations, however. If certain operations were carried out below the minimum amount, then often only because of the allowable exceptions or emergencies, it had not been. In addition, there were only minor shortfalls. The Association therefore proposes a flexible minimum quantities, which allowed for the participation of the hospitals in the care.