Reforming Emergency Care: Addressing the Challenges in Germany's Healthcare System

The emergency care system in Germany is on the brink of reform, highlighting the urgent need for improved coordination and enhanced public competency in emergency situations.

Patients often find themselves grappling with uncertainty regarding their health conditions, questioning whether their symptoms are critical or trivial. This uncertainty is a significant aspect of the current emergency care landscape, as noted by healthcare professionals.

Surveys conducted in various regions reveal a striking statistic: 76% of residents express a lack of confidence in performing life-saving measures, a sentiment that increases proportionally with the time elapsed since their last first aid training. This hesitation can have dire consequences, particularly in life-threatening situations such as cardiac arrest, where immediate action is crucial.

Many individuals are also unaware of the appropriate emergency contact numbers, such as 112 for fire and rescue services and 116 117 for medical emergencies. This lack of knowledge often leads to unnecessary visits to emergency rooms, which are already overwhelmed. In 2024 alone, emergency departments treated 12.4 million patients, with approximately 40% of those cases not constituting true emergencies. This misuse of resources highlights a broader issue within the emergency response framework.

The inefficiency of crowded emergency rooms serves as a clear illustration of the systemic challenges faced. The need for reform has been recognized by various political figures, including former federal minister Jens Spahn, and has been further advanced by his successor, Karl Lauterbach, who introduced a legislative proposal in October 2024 aimed at overhauling emergency care. The proposed legislation includes the establishment of centralized emergency call centers that would streamline responses for both 112 and 116 117 calls.

Moreover, larger hospitals are set to feature emergency centers that will work in tandem with general medical practices. These centers aim to enhance pediatric emergency services and provide a systematic approach to initial assessments. Future plans may also include the capability to schedule follow-up appointments with primary care or specialist physicians.

However, concerns remain regarding the implementation of these reforms, particularly in rural areas where access to emergency care is limited. Questions about staffing these new facilities, given the existing shortage of healthcare professionals, are prevalent among experts in the field.

Involving patients in the reform process is deemed essential to ensure that they are adequately informed about the changes to existing and new emergency care structures, thereby reducing misdirected calls for help. Experts also express skepticism about allowing patients continued direct access to emergency rooms without prior consultation.

Another notable gap in the proposed reforms is the exclusion of emergency services from the current legislative framework. Nonetheless, groundwork for enhancing emergency preparedness is already underway. Initiatives in cities like Wiesbaden have successfully trained approximately 18,000 students in essential first aid skills, fostering a culture of readiness among younger generations. The enthusiastic reception of these programs by students underscores the potential for widespread competency in emergency response.

Moving forward, it is crucial to integrate these training programs into a broader health education framework, ensuring that the population is well-equipped to handle emergencies.

These pertinent issues will be discussed in depth at an upcoming congress organized by the German Society for Internal Medicine, scheduled for May 3 to 6 in Wiesbaden. This event will include a dedicated patient day focusing on essential knowledge for emergency situations.