Help for hospitals: mystery of "missing" intensive care beds

At the end of June, the Ministry of Health was looking for around 7,300 intensive care beds, for which millions of funds had flowed. After Contrasts-Research, the ministry apparently had a wrong starting number.

In mid-March, at the beginning of the pandemic, Federal Minister of Health Jens Spahn asked the hospitals to double the number of intensive care beds. To this end, the federal government has funded over 10,000 new intensive care beds with around 530 million euros. At the same time, Spahn obliged the clinics to report their free intensive care beds on a daily basis to a register specially created for this, the so-called DIVI register. In the worst-case scenario, patients should be able to be quickly transferred to hospitals with vacant intensive care beds.

3100 beds less than expected

At the end of June, this DIVI intensive care registry showed around 32,411 intensive care beds across Germany. But according to a calculation by the Federal Ministry of Health (BMG), the DIVI register should have displayed 39,716 intensive care beds at the time. Therefore, in a fire letter to the federal states at the end of June, it warned of a discrepancy of 7,305 beds. Had about this operation Contrasts exclusively reported.

Now it turns out from a contrast request to all countries: The calculation of the BMG was apparently incorrect. In fact, the clinics across Germany only had 26,150 beds before Corona, according to the result of the Kontraste survey. However, the BMG had assumed – probably incorrectly – an initial inventory of 29,262 intensive care beds. In total, there were around 3,100 fewer beds before Corona than assumed by the BMG.

Thin data base

The process is typical of the German health care system: a lot of money flows, but the data situation is thin. Until the outbreak of the corona pandemic, nobody knew how many intensive care beds there really were, let alone how many of them were designed for invasive ventilation. The DVI register now sheds light on this for the first time.

But even if you take into account that the BMG probably expected an initial inventory that was too high, there would still be a gap of around 4,200 intensive care beds for which funding had been received but which did not appear in the DIVI register. A discrepancy that the health ministries of the federal states explain to contrasts as follows:

The 50,000 euros in funding per intensive care bed were also used when an existing intensive care bed was merely "upgraded" and equipped with a device for invasive ventilation. This means that no additional intensive care bed is created, but that an existing bed only moves from the "low care" area to the "high care" area. How many beds this applies to is unclear, however.

Fire letter apparently leads to controls

Another reason for the alleged loophole could be that only ready-to-use intensive care beds may be reported to the DIVI register – that is, intensive care beds for which sufficient staff is available. The additional intensive care beds are available "as an asset", but can only be operated in an emergency, if all interventions that can be postponed are canceled, writes the Lower Saxony Ministry of Health. Recently, the DIVI register has shown precisely this "emergency reserve capacity": around 12,000 additional intensive care beds could therefore be activated within seven days.

The responses from the federal states also show that the responsible ministries were quite alarmed by the fire letter from the BMG. At least some health ministers set out contrasts in detail, how they check whether the new intensive care beds and ventilators have actually been purchased. Some countries have emphasized that they have invoices or delivery notes presented. Individual federal states also carried out on-site inspections.

What to do with the many intensive care beds?

In view of the rather empty intensive care units, the current question is rather: What to do with the many intensive care beds that are not needed beyond such a pandemic? In the BMG letter from the end of June, the federal states were asked not to approve any further intensive care beds. The DIVI register shows between 8,0,000 free intensive care beds per day that could be occupied. Most recently, unlike in spring, the virus has spread mainly among younger people, and significantly fewer people have had to go to hospital.

The BMG has apparently not yet found a complete explanation for the missing beds. At least it did not give a concrete answer to the contrasts question about how the initial inventory of 29,262 intensive care beds came about. In general, the BMG said that the differences were attributed, among other things, to the fact that the DIVI register actually only shows the number of operational beds with sufficient staff.

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