Medical lessons from the COVID-19 crisis

Redirecting or closed wards for COVID-19 patients treatment, postponed elective surgeries, and schedules for absolutely necessary treatments. Could these measures be a model for post-pandemic healthcare?

Using services more wisely and protecting resources

Redirected or closed hospital wards for the treatment of COVID-19 patients, postponed elective surgeries, and surgery schedules for only absolutely necessary treatments. With these measures, hospitals have created capacity for the treatment of COVID patients. The extent to which the measures taken can be a model for the time after the pandemic is also being discussed within the German Society for Internal Medicine (Deutsche Gesellschaft für Innere Medizin or DGIM).

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Not only since the Corona pandemic brought healthcare to the brink of the breaking point is it clear that urgently needed financial resources are lacking in many areas of our healthcare systems. "This state of affairs will not change even after the end of the Corona crisis, but on the contrary will tend to intensify," says Professor Dr. Sebastian Schellong, Chairman of the DGIM and Chief Physician of the Second Medical Clinic (Medizinischen Klinik am Städtischen Klinikum) at the Dresden Municipal Hospital, Germany. In view of falling tax revenues and an increased debt level, it is not expected that the public sector will be able - or willing - to compensate for the expected decline in health insurance contributions, says the Dresden angiologist. "Therefore, looking into the future, we have to consider how we can adapt the type and scope of service provision in hospitals and practices to the available funds," says Prof. Dr. Schellong.

Priority for necessary medical treatments

In order to create capacity for the care of COVID-19 patients, hospitals have significantly reduced their range of services and postponed non-urgent procedures. Patient demand has also decreased significantly over the past few months. "For acute life-threatening illnesses such as heart attacks or strokes, it is alarming that fewer patients are currently calling a physician. With less dangerous illnesses, on the other hand, not every postponed or cancelled treatment has negative consequences," says Schellong. According to the Dresden internist, the consequences of the current care situation for patients must therefore be researched. "In this way, we can find out which areas of medical care are indispensable and in which the current shortage has not had any negative consequences for the prognosis of certain courses of disease," says Schellong.

In order to close the ever-widening gap in the health care system between scarce financial resources and increasing demands, measures such as a lower staffing limit for physicians should also be discussed. "The floor staffing approach in nursing could serve as a model here," Schellong suggests. The reorganisation of the hospital landscape and the better interlinking of outpatient and inpatient care across sectoral boundaries are other possible solutions. "The goal of all measures must be to continue to guarantee high quality medical services with limited human and financial resources," says the DGIM Chairman.