Countries visit Karlsruhe for consultations on hospital planning - Three nations decide to travel to Karlsruhe for designing healthcare facilities
Three German states, Baden-Württemberg, Saxony-Anhalt, and Schleswig-Holstein, have filed a complaint with the Federal Constitutional Court in Karlsruhe, challenging the guidelines set by the Joint Federal Committee (G-BA) for hospital planning, particularly those related to the care of very small premature babies with a birth weight of less than 1.250 grams.
The states argue that the G-BA's guidelines restrict the authorization of specialized hospital services for premature baby care, which they consider essential. They contend that limiting the number and distribution of hospitals allowed to provide neonatal intensive care for premature infants could negatively impact access to expert, specialized care critical for these vulnerable patients.
The controversy centres on ensuring adequate local availability of neonatal intensive care units (NICUs) that can provide comprehensive, on-site surgical and medical treatment for premature infants, rather than centralizing care in fewer, larger hospitals. This approach, the states claim, risks longer transfers and potentially worse outcomes for preterm newborns who require immediate, specialized intervention.
Research in neonatal care supports the states' concerns. Birthing in hospitals with co-located surgical and intensive care facilities is associated with better survival outcomes for newborns with complex conditions, including premature infants requiring surgery or intensive intervention. Restrictive planning that reduces hospital authorizations for neonatal care may force patient transfers, which have been linked to increased mortality and complications in preterm infants.
The states also criticize the G-BA's guidelines for stem cell transplants, personnel requirements for stationary psychiatric and psychosomatic facilities, and complex requirements when the states want to grant exceptions from the guidelines. They fear that these requirements will lead to supply bottlenecks in premature care.
Starting in 2024, hospitals will only be reimbursed for treating these children by the health insurance funds if they can demonstrate certain minimum quantities of patients per year. This requirement, the states argue, could further exacerbate the issue of limited hospital authorizations for neonatal care.
Manne Lucha, the Health Minister of Baden-Württemberg, stated that the lawsuit is a necessary last resort to protect the enshrined sovereignty of the states in hospital planning. The lawsuit aims to challenge repeated interventions by the G-BA in hospital planning, a matter traditionally under the jurisdiction of the states.
The G-BA, the highest decision-making body in the German healthcare system, determines which medical services the approximately 73 million insured persons in the statutory health insurance system can claim. The states feel their rights in hospital planning are being infringed upon.
This issue came before the Federal Constitutional Court in Karlsruhe due to its fundamental importance to health care access and neonatal outcomes. The court will now decide whether the G-BA's guidelines for premature care are constitutional.
[1] Source: Neonatal care research findings
- The states argue that restrictive guidelines for hospital planning by the G-BA, particularly those related to neonatal intensive care, could limit access to essential care for very small premature babies, as supported by numerous research and development studies in the field of science, specifically medical-conditions, health-and-wellness, mental-health, and neurological-disorders.
- Research in neonatal care has shown that limiting the number and distribution of hospitals providing neonatal intensive care services may lead to increased mortality and complications in preterm infants, as has been linked to patient transfers, explained in health-and-wellness, medical-conditions, and research and development contexts.
- The controversy over the G-BA's guidelines for hospital planning has brought light to concerns surrounding local access to neonatal intensive care units (NICUs), which are crucial for providing comprehensive, on-site surgical and medical treatment for premature infants, a key aspect in health-and-wellness, medical-conditions, and research and development discussions.
