This doesn't look like a Germany only problem to me.
The UK has this problem, the US…
This is a classical textbook resource allocation problem. Our ideologues have a theriac like cure-all for this. Their religion calls this supreme being "the market".
Patients with a regular source of care used the emergency department more appropriately than did patients without a regular source of care. […] Conclusions: Public emergency departments could refer large numbers of patients to appointments at primary care facilities. This alternative would be viable only if the availability and coordination of primary care services were enhanced for low-income populations. [From: Primary care and public emergency department overcrowding.]
Lack of coordination, lack of (not only monetary) resources, increase of demand and run-for-profit cost-cutting and funding-slashing – all working nicely together.
Frequent Overcrowding in U.S. Emergency Departments: Abstract. Objective: To describe the definition, extent, and factors associated with overcrowding in emergency departments (EDs) in the United States as perceived by ED directors.[…] Conclusions: Episodic, but frequent, overcrowding is a significant problem in academic, county, and private hospital EDs in urban and rural settings. Its causes are complex and multifactorial.
Unfortunately, this is a systemic and structural problem of those politics we chose to endure and tolerate.
Overcrowding in the nation’s emergency departments: Complex causes and disturbing effects: Ten years ago, serious overcrowding in emergency departments became a national issue. Although temporary improvement of the problem occurred, the issue of ED overcrowding has now resurfaced and threatens to become worse. Overcrowding is caused by a complex web of interrelated issues described in this article. ED overcrowding has multiple effects, including placing the patient at risk for poor outcome, prolonged pain and suffering of some patients, long patient waits, patient dissatisfaction, ambulance diversions in some cities, decreased physician productivity, increased frustration among medical staff, and violence. Solving the problem of overcrowding will not only require a major financial commitment from the federal government and local hospitals, but will also require a cooperation from managed care. Unless the problem is solved in the near future, the general public may no longer be able to rely on EDs for quality and timely emergency care, placing the people of this country at risk.
Among the reasons listed, there are quite a few redundant words used:
- Increased complexity and acuity of patients presenting to the ED
- Overall increase in patient volume
- Managed care problems.
- Lack of beds for patients admitted to the hospital.
- Avoiding inpatient hospital admission by “intensive therapy” in the ED.
- Delays in service provided by radiology, laboratory, and ancillary services.
- Shortage of nursing staff
- Shortage of administrative/clerical support staff
- Shortage of on-call specialty consultants or lack of availability.
- Shortage of physical plant space within the ED
- Problems with language and cultural barriers.
- Shortage of house staff who rotate through teaching hospital EDs
- Increased medical record documentation requirements.
- Difficulty in arranging follow-up care.
Notice there are factors indicating increased quality of health care: overall numbers increase is partially the result of better quality leading to an ageing population. Then there is this stupid taylorised over documentation for quality controlling (McKinseyed to death), thought of as good idea, terrible outcome in current practice.
But most indicative in this analysis:
Shortages everywhere! Sounds like socialism is back? Or is this driven by greed?
