[Exposure to limited resources in the gastroenterology - results of a survey of hospital physicians].
Background and research question:The hospital sector is currently characterized by a high economic pressure. As well the DRG system as the investment financing by the federal states imply financial limitations. Hospitals react to this situation by trying to reduce costs and to increase case volume. It is questionable whether and to what extent patient care and the working conditions of the physicians are affected by these circumstances. Especially, gastroenterological patients were considered to be insufficiently covered by the DRG system in the past. Therefore, this study focuses on the gastroenterology.Method:Based on prior studies and several semi-structured interviews with gastroenterologists working in hospitals a discipline-specific questionnaire was developed. Three versions of the questionnaire were differentiated to correspond to the respective experiences of the target population (chief physician, senior physician, assistant physician). All in all, 1751 members of the "Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten" (DGVS) were addressed. The questionnaire was answered by 642 participants resulting in a response rate of 36.7 %. The answers were interpreted by using descriptive and multivariate analyses.Results:A significant economic pressure is perceived by the participating gastroenterologists. This pressure manifests itself primary in perceived deficits in nursing care and human attention towards the patients. Moreover, the work satisfaction is negatively affected. Identified difficulties in the personnel recruitment can only be partially attributed to economic reasons. However, rationing of services is relatively seldom. Also, a financially-oriented overprovision is not perceived as a primary concern. In general, assistant physicians were a bit more skeptical about the situation in the gastroenterology, e. g. patient care, than the chief physicians.Conclusions:In total, the situation in the gastroenterology is similar to other stationary disciplines. However, in certain questions (e. g. increased surgery) differences are observed. Concerning perceived insufficient coverage of gastroenterologic services in the DRG system further projects should be initiated to improve coverage of these services.
L
L
Kerkemeyer
A
A
Reifferscheid
N
N
Pomorin
J
J
Wasem
D001291:Attitude of Health Personnel; D000072102:Gastroenterologists / Q000191:economics* / Q000706:statistics & numerical data; D005762:Gastroenterology / Q000191:economics* / Q000706:statistics & numerical data; D005858:Germany; D015276:Health Care Rationing / Q000191:economics* / Q000706:statistics & numerical data; D019538:Health Care Surveys; D020445:Hospitalists / Q000191:economics* / Q000706:statistics & numerical data; D007588:Job Satisfaction; D000078329:Workforce; D016526:Workload / Q000191:economics* / Q000706:statistics & numerical data