Hospital report: Minimum case numbers increase quality and efficiency

“Practice makes perfect.” Does this saying also apply to medical care? There is scientific evidence of the link between case numbers and quality, particularly for complex surgical procedures. Helsana has compiled a report on minimum case numbers in collaboration with the German health insurance provider Barmer, which compares the rules applicable in both countries and shows that higher case numbers contribute to better quality and greater efficiency.

The key findings

• In both countries, minimum case numbers were set for expensive treatments, mainly in highly specialised medicine.
• Using their billing data from 2013 to 2018, the health insurance providers analysed whether hospitals achieved the minimum case numbers and found considerable differences.
• In Germany, 4,300 patients were treated in hospitals that did not meet their minimum case numbers. Depending on the procedure, this equates to 2–15% of patients.
• In Switzerland, this applies to 5,200 patients – to up to 27% depending on the procedure.
• “Minimum case numbers” are recognised as a quality criterion in both countries and are becoming increasingly important. But to date they have been applied cautiously, with minimal consequences for non-compliance.

Both health insurance providers see a need for higher case numbers and effective sanctions. More transparency is needed with respect to the minimum case numbers set and achieved, as well as the associated quality improvements – not least for patients.