(New: Details)

BERLIN (dpa-AFX) - Patients will soon be able to compare the services and treatment quality of hospitals in Germany using a government online atlas. That's according to plans by Health Minister Karl Lauterbach (SPD), which the federal cabinet launched on Wednesday. The "transparency directory" is to start in April 2024 and inform as interactive portal understandably about the respective offer at country widely approximately 1700 hospital locations. Criticism came from the states and the industry. The law is intended to complement a fundamental reorganization of clinics with changes in financing, on which the federal and state governments are working together.

Lauterbach said in Berlin, "More transparency is overdue and helps hospitals and patients alike." Doctors would be asked again and again, "Which hospital is how good for what?" Everywhere in Germany, he said, nurses and doctors were doing fantastic work. Nevertheless, not everyone can do everything. "We still have the situation where there are senior physicians who perform a knee operation on Monday and a bowel operation the next day." That, of course, is not a quality of care one would want, he said.

In acute emergencies, it is usually necessary to get to the next suitable hospital as quickly as possible. A better orientation is to offer the hospital atlas for clicking through however with plannable treatments, for which one can drive also some kilometers more to a hospital.

The directory: Specifically, the portal is intended to show whether a hospital offers a service - including a specialist department. The draft provides for 65 such service groups, which describe medical services in more detail - for example, infectious diseases, ophthalmology, urology or intensive care. In this way, it would be possible to see whether a cancer operation was performed in general surgery or in a more specialized cancer surgery department, Lauterbach said. Data on treatment experience (case numbers), staffing ratios for specialists and nurses, and complication rates for selected procedures should also be available in an understandable way.

The data: The hospitals are to report further data, for example on staff numbers. Via two institutes, these are to be merged with other quality data, processed and also updated. Lauterbach emphasized that the aim is to provide more in-depth information than is the case with existing offerings. Consumer groups are also pushing for more transparency. The health expert of the federal association, Thomas Moormann, said that there was a "patchwork" of different search portals. One could not see, however, how successful treatments of a clinic are with concrete problems. For a well-done directory to have added value, however, the actual outcome quality of the treatment must be asked of patients and reflected in it.

Expertise and distance: Lauterbach made it clear that a closer look at treatment quality in the dense network of clinics does not have to lead to much longer distances. He referred to the analysis of a government commission, according to which just under 5,000 more people a year could survive in the first year after a stroke - if all patients only went to clinics with special departments (stroke units). The average journey time would increase by two minutes to 23.4 minutes if the focus was on specialty sites.

Warnings: Protests came from the German Hospital Association (DKG) against a classification of hospitals according to levels - from basic care close to home to maximum care providers such as university hospitals. The basis should be the 65 service groups. If a hospital has few of these, but a lot of experience in certain treatments, it is assigned to a lower "level," the DKG complained - and the message for patients would be to go better to a hospital with a higher "level," although the quality would be excellent. The German Foundation for Patient Protection said it was right to also display the frequency of complications. However, it must be prevented that younger, promising patients are treated preferentially. This would be discrimination against the elderly, the chronically ill and those in need of care.

The role of the federal states: There had already been turmoil about the project in the struggle for the planned general reorganization of the hospitals. The states objected to a stronger control function of the "levels" in this reform and insisted on their planning sovereignty. The federation makes the transparency law therefore in own direction - and in the Upper House of Parliament it is not subject to agreement, as Lauterbach said immediately. Bavaria's Health Minister Klaus Holetschek (CSU) warned of uncertainty and a threat to the acceptance of smaller hospitals in particular. In addition also an overloading of larger special hospitals threatens by easy cases. The chairman of the state department heads, Manne Lucha (Greens) from Baden-Württemberg, warned against further bureaucracy.

The future of clinics: Lauterbach let it be known that he is nevertheless counting on further joint work with the states on the actual hospital reform. A bill is to be drafted for this purpose. The core is to change the remuneration with lump sums for treatment cases, in order to loosen clinics of financial pressure to ever more cases. Instead, they should receive a large share of the remuneration simply for providing services. Lauterbach emphasized that this would also safeguard small hospitals. And it would not be justifiable to say: In order for a clinic to survive in any case, it must remain non-transparent in order to continue to be able to charge for poor quality./sam/DP/ngu