Results of the 11th Survey of the German Society for Neurology on the Structure of Neurological Departments in Germany

The German Neurological Society conducts a survey of the structure of neurological in-patient care every other year. The present survey covers the year 2013, Multiple emissions of the survey improved the response rate to 66% Neurological departments got increasingly involved in interdisciplinary emergency rooms. Although emergency cases dominate everyday Neurology practice 24/7 availability of diagnostic infrastructure did not improve. Actually, the local lack of 24/7 MRI facilities or CSF diagnostics is incompatible with comprehensive Neurologic care according to current guidelines. Interventional angiography is available in even less centres than 2 years ago. The majority of Neurology departments provides in- and outpatient care facilities. When compared to results from the former survey (covering 2011), the department size (here: number of beds) remained roughly unchanged. However, the upper quartile of departments tended to increase their beds. In all departments irrespective of size, there was a tendency towards an increased number of cases. Congruently, the length of stay decreased to an average of 6.5 days. This is one day shorter than the German hospital average across all disciplines, and the extent of decrease exceeds the average development in German hospitals. This was accompanied by a slight reduction of the average per case proceeds (casemix index). Structures of staff was heterogeneous, and many departments did not succeed in differentiating personal resources dedicated to inpatient and outpatient care duties nor those responsible for duties like research or teaching. Some departments suffered from shortage of personnel but this did rarely interfere with patient care. Although certification processes are common in most of the departments the impact on quality of care remains elusive, To date, incentives for patient tailored quality management are missing.