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[从损伤类型诊疗程序(VAV)诊所的角度看德国职业安全与健康协会(DGUV)的新治疗程序]

[The new treatment procedures of the DGUV from the perspective of an injury type procedure (VAV) clinic].

作者信息

Oberst M

机构信息

Klinik für Orthopädie, Unfall- und Wirbelsäulenchirurgie, Ostalb-Klinikum Aalen, Im Kälblesrain 1, 73430, Aalen, Deutschland.

出版信息

Unfallchirurg. 2017 Sep;120(9):790-794. doi: 10.1007/s00113-017-0393-3.

Abstract

The new treatment procedures of the German Statutory Accident Insurance (DGUV) have ramifications for the injury type procedure clinics (VAV) from medical, economic and structural aspects. Whereas the latter can be assessed as positive, the medical and economical aspects are perceived as being negative. Problems arise from the partially unclear formulation of the injury type catalogue, which results in unpleasant negotiations with the occupational insurance associations with respect to financial remuneration for services rendered. Furthermore, the medical competence of the VAV clinics will be reduced by the preset specifications of the VAV catalogue, which opens up an additional field of tension between medical treatment, fulfillment of the obligatory training and acquisition of personnel as well as the continually increasing economic pressure. From the perspective of the author, the relinquence of medical competence imposed by the regulations of the new VAV catalogue is "throwing the baby out with the bathwater" because many VAV clinics nationwide also partially have competence in the severe injury type procedure (SAV). A concrete "competence-based approval" for the individual areas of the VAV procedure would be sensible and would maintain the comprehensive care of insured persons and also increase or strengthen the willingness of participating VAV hospitals for unconditional implementation of the new VAV procedure.

摘要

德国法定事故保险(DGUV)的新治疗程序在医疗、经济和结构方面对伤害类型程序诊所(VAV)产生了影响。虽然后者可被评估为积极的,但医疗和经济方面却被视为消极的。问题源于伤害类型目录的部分表述不清晰,这导致在与职业保险协会就所提供服务的经济报酬进行谈判时不愉快。此外,VAV目录的预设规范将降低VAV诊所的医疗能力,这在医疗治疗、完成强制性培训和人员招聘以及持续增加的经济压力之间开辟了一个额外的紧张领域。从作者的角度来看,新VAV目录的规定所导致的医疗能力丧失是“把洗澡水和婴儿一起倒掉”,因为全国许多VAV诊所也部分具备重伤类型程序(SAV)的能力。对VAV程序的各个领域进行具体的“基于能力的批准”将是明智的,这将维持对被保险人的全面护理,并增加或加强参与的VAV医院无条件实施新VAV程序的意愿。

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