The Berlin Hospital Association (BKG) expects that the capital's hospitals will have to switch back to emergency operations. The many Corona infections, which take severe courses, put a strain on hospitals, which are currently still treating tens of thousands of patients with common ailments and injuries.

"Berlin hospitals are foreseeably in a new crisis mode. The numbers of Covid 19 patients are rising - both in intensive care and normal wards," BKG CEO Marc Schreiner told the Daily Mirror newspaper. "The hospitals are striving to distribute the Corona patients across the individual clinics. This time, this should also apply to cases treated in normal wards, so that care can be provided well throughout the city."

This refers to the so-called Save concept for intensive care patients, according to which Charité, as a Level I clinic, treats the most severe Covid 19 cases, most of which are permanently ventilated. Level II is 16 clinics, including the state-owned Vivantes hospitals, Unfallkrankenhaus Berlin, and the private Helios clinics, care for other severe corona cases. Level III clinics primarily care for intensive care cases that are not infected with Corona.

After the board of the Charité has already warned of "overload" due to Covid 19 cases, BKG managing director Schreiner is also talking about soon having to postpone so-called elective procedures: "We expect that scheduled treatments will increasingly have to be postponed in the coming weeks in order to be able to care for the increasing number of Covid 19 patients. Probably ten percent of hospital beds would soon have to be kept free for Corona cases - that's about 2,000 beds in Berlin."

Hospitals needed adequate compensation for the lost revenue from missed treatments and procedures. Hospitals had received appropriate per-bed hold-harmless payments from the federal government last winter to allow hospitals to conserve resources for Covid 19 cases.

Although there are currently still comparatively few severe Covid 19 cases, the situation is exacerbated by the fact that fewer intensive care beds are available nationwide than a year ago. The background to this is exhausted nursing staff who are absent due to illness or job changes. "The situation in pediatric wards should not be forgotten either," Schreiner said. "Infections with the respiratory syncytial virus, or RSV, are already putting a massive strain on staff and capacity there. Most recently, children from Berlin had to be transferred to Cottbus.

The German Doctors' Congress, which is currently meeting in Berlin, has called on the legislature to stop the commercialization of healthcare. For hospitals, the physicians are calling for a reform of the current revenue-oriented financing: "The remuneration system must no longer be geared exclusively to the economic efficiency of a hospital operation." Financing must be geared primarily to the need for care and thus to the costs of staff, buildings, and technology.

The system of flat-rate payments per case would have to be changed. Until now, hospitals have been paid by health insurers per billed diagnosis. Some of these cases are more "lucrative" than others: Outpatient treatments in emergency departments in particular often cost the clinics more than the insurers pay for them. Berlin's hospital association represents more than 50 hospitals of church, non-profit and private owners in all districts of the city.

Photo by Richard Catabay