Liechtenstein State Hospital

from Wikipedia, the free encyclopedia
Liechtenstein State Hospital
Sponsorship Liechtenstein State Hospital Foundation
place Vaduz
Country LiechtensteinLiechtenstein Liechtenstein
Coordinates 758 098  /  222522 coordinates: 47 ° 8 '5 "  N , 9 ° 31' 22"  O ; CH1903:  758,098  /  222522
beds 40
Employee 166
including doctors 18 + 60
Annual budget around CHF 29 million (2016)
founding 1892
Website www.landesspital.li
Template: Infobox_Krankenhaus / Logo_misst
Liechtenstein State Hospital - view from the southeast

The Liechtensteinische Landesspital (LLS) is the only public hospital in the Principality of Liechtenstein . It has its seat in Vaduz and is organized as an independent foundation under public law.

history

Beginnings

The history of the hospital is closely linked to the general care of the poor and sick in Liechtenstein. From the 1820s onwards, various plans for the construction of a Liechtenstein hospital emerged, but these failed due to financial or political hurdles. Finally, based on a resolution by the Liechtenstein Parliament, it was decided to set up decentralized medical care in the form of citizens' homes from the second half of the 19th century. In the course of this expansion, a citizens' home was also built in Vaduz in 1892. This was founded by the state physician Felix Batliner and the patients were cared for in collaboration with the Sisters of Charity in Zams . In the early 1920s, the community center was expanded into a hospital ward and a maternity ward. In the following years there was a further expansion - u. a. with an operating room.

Expansion and restructuring

Former ambulance of the Liechtenstein Red Cross

In 1956, the state parliament voted in favor of the new or expansion of the hospital, which was only implemented after a referendum at the municipal and state levels between 1977 and 1981. In 1971, the Liechtenstein Red Cross launched an actual rescue service, with the State of Liechtenstein having had an ambulance since 1955.

At the beginning of 2000, the hospital passed by law from the ownership of the municipality of Vaduz to state ownership , which has been a foundation under public law ever since. At the same time, the name was changed from "Vaduz Hospital" to "Liechtenstein State Hospital". In the following years, various conversions and extensions were implemented - for example in 2004 with the construction of a new bed wing and in 2009 with the commissioning of a magnetic resonance tomograph (MRI) .

Failed new construction plans in 2011

Due to the relatively old age of the buildings and in view of the demographic development, the Liechtenstein government developed a project for a new building for the Liechtenstein State Hospital. A new hospital should be built at the same location with a total commitment loan of CHF 83 million.

After the Liechtenstein state parliament had approved the commitment loan, a non-partisan committee held the referendum . In the referendum of 28./30. October 2011 the loan was rejected with a majority of 58.1%.

A consultation analysis showed that the overwhelming majority of the population wanted their own hospital, but changes in the cooperation and in the operating model (hybrid model: chief physician and attending physician model) should be sought. At the same time, it became clear that the investment costs of around CHF 83 million were not primarily the decisive factor.

Realignment

As a result of the rejection of the commitment loan for a new building, the responsible persons at the Liechtenstein State Hospital and the government decided on various innovations and changes. In addition to personnel changes (board of trustees, hospital management), three central elements were pursued in the redesign. The so-called “Zurich Model” is intended to follow fixed rules with regard to operation and organization, thus guaranteeing high quality. At the same time, the decision was made to set up a new hybrid operating model as a combination of chief physician and attending physician hospital. In addition, vertical cooperation with a central hospital was sought.

In January 2014, the Cantonal Hospital of Graubünden in Chur was selected as the central hospital, as, according to the hospital management, it would best meet the needs of the state hospital and the population. In addition, various structural measures have been implemented: For example, a new emergency station was built, the operating theaters and central sterilization were renovated and the helicopter landing pad was refurbished.

In 2014 but the decision was made, the maternity ward to close: The departure of three attending physicians in the field of gynecology would have necessitated a reorganization of obstetrics. Although various scenarios were examined, no solution could be found that met the quality requirements, according to the hospital management. However, the hospital management also emphasized that reopening the maternity ward could be considered in the future. A prerequisite for this - in addition to the premises - would be a corresponding expansion of the surgery (including anesthesia ) in order to be able to meet the quality requirements. The first steps in this direction have been taken with the employment of senior doctors in the field of surgery and anesthesia.

Key role during the COVID-19 pandemic

After the COVID-19 pandemic in Liechtenstein had appeared since March 2020 as part of the global COVID-19 pandemic that started in the People's Republic of China in December 2019 , the State Hospital quickly assumed a key role in the country. The hospital set up an advice line on +423 235 45 32 for suspected cases. The hotline can be reached Monday through Friday from 8:00 a.m. to 6:00 p.m. Liechtenstein residents who tested positive for the SARS-CoV-2 virus are isolated in home quarantine and, in the event of severe disease, in the state hospital. The first person was quarantined on March 3. By March 23, 2020, the number of infected people rose to 51 people living in Liechtenstein. Up to this day, 750 suspected corona cases had already been tested at the state hospital.

On March 23, 2020, the Liechtenstein government announced several measures in the health system. Since the increasing number of cases in the country means that further serious illnesses must be expected, in addition to the previous beds in the Liechtenstein State Hospital, additional capacities are to be created in the St. Peter and Paul House in order to prepare for this situation. A “drive-through test facility” should also be set up, with which one can better test suspected cases in Liechtenstein. So far, samples for laboratory tests have been taken in the state hospital. After prior telephone registration, the suspected cases to be tested can in future appear in their own car for sampling and remain seated in the car during the test process. The hospital can thus concentrate better on regular operations. In addition to the existing ventilators in the State Hospital, five more ventilators were purchased in the course of the Corona crisis in March 2020. If the situation requires it, they want to set up additional ventilation places in the hospital.

Planned new building

Although the infrastructure of the State Hospital has been renewed in various areas in recent years, various structural deficiencies have persisted (e.g. driveway, patient room, technical installations). This fact caused the government to examine different options for a comprehensive renovation of the hospital, which came to the conclusion that a new building at a new location was the best solution. The state parliament first dealt with the new construction plans in February 2019: On the one hand, it was largely undisputed that Liechtenstein should continue to have its own hospital. On the other hand, a comprehensive renovation or expansion of the existing building as well as a new building at the existing location was also judged to be ineffective by the state parliament. Instead, the government was commissioned on the one hand to examine a possible conversion of an empty private hospital building and on the other hand to examine a new building at various possible locations.

In July 2019, the government submitted a financial resolution to the state parliament for the construction of a new state hospital on the so-called “Wille Areal” in the immediate vicinity of the Old Rhine Bridge Vaduz-Sevelen . A hospital with 43 beds (all in single rooms) was planned, with space also being provided for a maternity ward. The total cost of the project should amount to 72.5 million francs, whereby the municipality of Vaduz had agreed to contribute a contribution of 7 million francs from a hospital building fund administered by the municipality.

In the meeting on September 5, 2019, the state parliament approved the loan with a majority of 17 yes-votes. The state parliament also unanimously decided to hold a referendum. On November 24, 2019, the Liechtenstein electorate finally approved the loan for the new building with a yes share of 56.2%. The move into the new building is planned for 2025.

organization

The Foundation's bodies are in accordance with art 7 LLSG:

According to Art. 2 LLSG, the main purpose is to run a state hospital . The Foundation can perform all activities related to this purpose, in particular basic medical care for the Liechtenstein population must be ensured. The foundation is owned by the Principality of Liechtenstein and is subject to the supervision of the government in accordance with Art. 78 Para. 4 LV .

tasks

The government defines the services to be provided and the requirements with regard to the quality and cost-effectiveness of the service provision in the form of a service contract to the state hospital. The definition of the service mandate takes into account the service agreements made with the surrounding contractual hospitals .

A distinction is made between “minimum services” (minimum scope of services), “optional services” and “excluded services”: The latter includes services (e.g. invasive cardiology, heart surgery, organ transplants) which the State Hospital is not allowed to offer. Optional services (e.g. orthopedics, urology), on the other hand, may be included in the range of services by the Board of Trustees if the services are of high quality and economical and the existing range is meaningfully supplemented.

The following medical tasks and offers existed or exist:

until 2008 since 2008
Internal medicine, including services in the field of general internal medicine, non-interventional cardiology, pulmonology, gastroenterology, rheumatology and medical oncology, nephrology without a dialysis unit and infectiology; Internal medicine, including services such. B. in cardiology, pulmonology, gastroenterology and medical oncology; Basic care in the field of infectiology;
general pediatrics; Pediatrics;
Ophthalmology;
Dermatology; Dermatological offer by attending physicians;
general neurology; Neurology;
Geriatrics and acute geriatrics; Geriatrics;
Psychiatry and psychosomatics; psychiatric care in the sense of a crisis intervention offer;
Surgery, including services in the field of general surgery. General surgery includes most of abdominal surgery, soft tissue surgery, peripheral vascular surgery, trauma surgery, orthopedics and urology; Surgery with a focus on general and trauma surgery; Orthopedic surgery and traumatology of the musculoskeletal system; Urology; Plastic-reconstructive and aesthetic surgery; Oral and maxillofacial surgery;
Gynecology and obstetrics, including the possibility of initial neonatal treatment; Gynecology;
Oto-Rhino-Laryngology (ORL); Oto-Rhino-Laryngology (ORL);
Anesthesia including shock and pain treatment, the recovery room and the emergency ward with temporary operational readiness; Anesthesia and emergency care with 24-hour provision for external and internal emergencies;
Examinations on the corpse;
forensic medicine;
conventional radiology and sonographic examinations as well as the hospital pharmacy and the routine laboratory; necessary support areas e.g. B. with radiology (including conventional X-ray, MRI, CT) and laboratory;
Physiotherapy and occupational therapy as well as speech therapy; Physiotherapy offers;
Networking with Spitex . inpatient follow-up and transitional care;
Palliative medicine;
Care in special or extraordinary situations.

The Liechtenstein State Hospital also had the task of operating the emergency number 144 until 2017 . Since then, the medical emergency number has been integrated into the national emergency call and operations center of the Liechtenstein National Police .

Legal bases

The legal basis for the existence and organization as well as obligations of the hospital is the law of October 21, 1999 on the Liechtenstein State Hospital (LLSG). The law on the control and monitoring of public companies applies in addition.

In emergency situations, the law of April 26, 2007 on the protection of the population (Civil Protection Act) must also be consulted. The hospital must periodically check the functionality of the internal emergency and operational planning and is responsible for updating it.

The statutes of the foundation, the organizational regulations, the owner strategy, the service mandate and the relevant collective agreements also exist.

Within the Liechtenstein government, the hospital is assigned to the Ministry of Society.

financing

The State Hospital finances its tasks in accordance with Art. 5 LLSG

  • Payment for services provided by patients and insurers;
  • a state contribution;
  • further income.

The state contribution is granted as a global credit. If required, the State of Liechtenstein provides an interest-bearing business loan and, if necessary, assumes further investment costs. The state contribution for 2014 is 7,394,000 Swiss francs.

Until 2009, the operating deficits of the Liechtenstein State Hospital Foundation were borne by the state and the state was able to pay the annual operating contribution in the form of a global credit.

Publications

The in-house newspaper of the Liechtensteinisches Landesspital usually appears three to four times a year with a circulation of 400 (publisher Liechtensteinisches Landesspital).

An annual report is published by the Board of Trustees.

literature

  • Manfred Gantner; Johann Eibl: Fulfilling public tasks in a small state. UT: the example of the Principality of Liechtenstein . 1st edition. Liechtenstein Academic Society, Vaduz 1999, ISBN 3-7211-1041-2 .

Web links

Individual evidence

  1. ↑ We do not build excess capacity. In: Liechtenstein Fatherland. 10/26/2019.
  2. ↑ Report and application from the government No. 80/2019 to the Landtag of the Principality of Liechtenstein regarding the approval of a commitment loan for the construction of a new state hospital and the approval of the reallocation of the Vaduz property no.2506 from financial assets to administrative assets, p. 13.
  3. ↑ Report and application from the government No. 80/2019 to the Landtag of the Principality of Liechtenstein regarding the approval of a commitment loan for the construction of a new state hospital and the approval of the reallocation of the Vaduz property no.2506 from financial assets to administrative assets, p. 13.
  4. ↑ Annual Report 2016, p. 28
  5. ↑ The abbreviation LLS is not an official (official) abbreviation. The state hospital is also often referred to as the Vaduz hospital or, more rarely, the state hospital.
  6. ↑ Art. 1 law of November 20, 2009 regarding the amendment of the law on the Liechtenstein State Hospital, LGBl. 370/2009.
  7. ^ Historical Lexicon of the Principality of Liechtenstein. Volume B, pp. 889-890.
  8. ^ Ambulance service in Liechtenstein . Website of the Liechtenstein Red Cross. Retrieved February 4, 2014.
  9. ^ Historical Lexicon of the Principality of Liechtenstein. Volume B, pp. 889-890.
  10. ↑ Portrait of the State Hospital . Website of the Liechtenstein State Hospital. Retrieved July 13, 2017.
  11. ↑ Report and application of the Liechtenstein Government, No 54/2011 .
  12. ↑ Result of the vote 28./30. October 2011 . Government information and communication: voting results. Retrieved July 13, 2017.
  13. ↑ Voting Analysis . Website of the Liechtenstein Institute. Retrieved July 13, 2017.
  14. ↑ Realignment of the State Hospital ( Memento of the original dated February 22, 2014 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. . Liechtenstein Fatherland from October 19, 2012. Retrieved on February 4, 2014. @1@ 2Template: Webachiv / IABot / www.landesspital.li
  15. ↑ Cooperation with the Cantonal Hospital of Graubünden . Liechtenstein Fatherland from January 29, 2014. Accessed on February 4, 2014. The distance between Vaduz and Chur is around 40 km (journey time approx. 30 minutes) , and between Vaduz and the Feldkirch State Hospital 15 km (journey time approx. 25 minutes).
  16. ↑ Report and application by the Liechtenstein Government, No. 54/2017, p. 32 .
  17. ↑ Landespital must stop obstetrics . Media information from the Liechtenstein State Hospital of January 15, 2014, p. 2.
  18. ↑ Landespital must stop obstetrics . Media information from the Liechtenstein State Hospital of January 15, 2014, p. 2.
  19. ↑ Landespital must stop obstetrics . Media information from the Liechtenstein State Hospital of January 15, 2014, p. 2.
  20. ↑ State hospital creates head anesthetist position . Medieninside.ch, August 30, 2016.
  21. ^ Liechtensteinisches Landesspital: Liechtenstein State Hospital . Online at www.landesspital.li. Retrieved March 20, 2020.
  22. ^ Government of Liechtenstein: Hotlines for questions in connection with the coronavirus . February 27, 2020. Online at www.vaterland.li. Retrieved March 20, 2020.
  23. ↑ Young man tested positive for corona virus .
  24. ^ A b Government of Liechtenstein: Additional beds and drive-through test facility . March 23, 2020. Online at www.regierung.li. Retrieved March 23, 2020.
  25. ↑ a b Vaterland.li: So far 750 people have been tested in Liechtenstein . March 23, 2020. Online at www.vaterland.li. Retrieved March 23, 2020.
  26. ↑ Report and application of the Liechtenstein Government, No. 16/2019, pp. 48-52.
  27. ↑ Report and application of the Liechtenstein Government, No. 16/2019, p. 8.
  28. ↑ Government should examine several LLS variants more closely. In: Liechtensteiner Volksblatt. February 28, 2019.
  29. ↑ Government should examine several LLS variants more closely. In: Liechtensteiner Volksblatt. February 28, 2019.
  30. ↑ Government should examine several LLS variants more closely. In: Liechtensteiner Volksblatt. February 28, 2019.
  31. ↑ Report and application of the government No. 80/2019 to the Landtag of the Principality of Liechtenstein regarding the approval of a commitment loan for the construction of a new state hospital and the approval of the reallocation of the Vaduz property no.2506 from financial assets to administrative assets.
  32. ↑ Report and application by the government No. 80/2019 to the Parliament of the Principality of Liechtenstein regarding the approval of a commitment loan for the construction of a new state hospital and the approval of the reallocation of Vaduz property No. 2506 from financial assets to administrative assets, p. 60/61.
  33. ↑ Report and application by the government No. 80/2019 to the Landtag of the Principality of Liechtenstein regarding the approval of a commitment loan for the construction of a new state hospital and the approval of the reallocation of the Vaduz property no.2506 from financial assets to administrative assets, p. 85.
  34. ↑ State Parliament for New Hospital Building - The people have the final say. In: Liechtensteiner Volksblatt. September 6, 2019.
  35. ↑ State Parliament for New Hospital Building - The people have the final say. In: Liechtensteiner Volksblatt. September 6, 2019.
  36. ↑ Result of the vote on November 24, 2019
  37. ↑ Report and application from the government No. 80/2019 to the Landtag of the Principality of Liechtenstein regarding the approval of a commitment loan for the construction of a new state hospital and the approval of the reallocation of the Vaduz property No. 2506 from financial assets to administrative assets, p. 88.
  38. ↑ See also Art 7 ff statutes of the State Hospital.
  39. ^ Until 2009: the administrative director and a hospital commission.
  40. ↑ See also Art. 3 Statutes of the State Hospital.
  41. ↑ Art 18 para. 1 LLSG.
  42. ↑ Art 3 LLSG.
  43. ↑ Report and application of the Liechtenstein Government, No. 54/2017, pp. 10, 12 .
  44. ↑ Owner strategy of the government of the Principality of Liechtenstein for the Liechtenstein State Hospital Foundation. November 2012.
  45. ↑ Owner strategy of the government of the Principality of Liechtenstein for the Liechtenstein State Hospital Foundation. November 2012.
  46. ↑ Ordinance of 19 September 2000 on basic medical care, LGBl 184/2000.
  47. ^ Ordinance of March 26, 2008 regarding the amendment of the ordinance on basic medical care, LGBl 84/2008. Current offer reproduced in accordance with the report and application of the government No. 54/2017 to the State Parliament of the Principality of Liechtenstein regarding the approval of a supplementary credit to ensure basic care in the Liechtenstein State Hospital, p. 30, last accessed on July 22, 2017 and the State Hospital 2016 Annual Report (PDF ), P. 33, last accessed on July 22, 2017.
  48. ↑ Close cooperation with the Cantonal Hospital of Graubünden .
  49. ↑ Report and application by the government No. 54/2017 to the State Parliament of the Principality of Liechtenstein regarding the approval of a supplementary credit to ensure basic services in the Liechtenstein State Hospital, p. 30, last accessed on July 23, 2017 and Annual Report State Hospital 2016 , p. 33f. , last accessed on July 23, 2017.
  50. ↑ Annual Report State Hospital 2016 , p. 33f. (PDF), last accessed on July 23, 2017.
  51. ↑ Report and application by the government No. 54/2017 to the Landtag of the Principality of Liechtenstein regarding the approval of a supplementary credit to ensure basic care in the Liechtenstein State Hospital, p. 30.
  52. ^ Annual Report State Hospital 2016 , p. 33f., Last accessed on July 23, 2017; see. also the website of the Liechtenstein State Hospital , last accessed on July 23, 2017.
  53. ↑ According to the Liechtensteiner Volksblatt , March 30, 2017, p. 8, acute geriatrics are to be rebuilt as basic care. See also Government Report No. 54/2017 to the State Parliament of the Principality of Liechtenstein regarding the approval of a supplementary credit to ensure basic care in the Liechtenstein State Hospital, p. 30 (PDF), last accessed on July 22, 2017.
  54. ↑ Point 2.3 Service mandate Liechtensteinisches Landesspital of March 18, 2008. Annual Report of the State Hospital 2016 , p. 33 (PDF), last accessed on July 22, 2017.
  55. ↑ Report and application by the government No. 54/2017 to the Landtag of the Principality of Liechtenstein regarding the approval of a supplementary credit to ensure basic services in the Liechtenstein State Hospital, p. 30 and Annual Report State Hospital 2016 , p. 13, 33f., Both last accessed on 22 July 2017.
  56. ↑ The maternity ward at the State Hospital was closed in 2014 and the offer was discontinued.
  57. ↑ Report and application by the government No. 54/2017 to the Landtag of the Principality of Liechtenstein regarding the approval of a supplementary credit to ensure basic care in the Liechtenstein State Hospital, p. 30.
  58. ↑ Point 2.5 Service mandate Liechtensteinisches Landesspital dated March 18, 2008. See also: Annual Report Landesspital 2016 , p. 33 (PDF), last accessed on July 22, 2017.
  59. ↑ Annual Report State Hospital 2016 , p. 33 (PDF), last accessed on July 22, 2017.
  60. ↑ Annual Report State Hospital 2016 , p. 19 (PDF), last accessed on July 23, 2017.
  61. ↑ Annual Report State Hospital 2016 , p. 33, last accessed on July 22, 2017.
  62. ↑ Annual Report State Hospital 2016 , p. 33, last accessed on July 22, 2017.
  63. ↑ For example, the state hospital can be obliged by the government to take on special functions (e.g. prior storage of vaccines, medicines, respiratory masks); see. Item 2.6 Performance mandate for the Liechtenstein State Hospital of March 18, 2008; as well as Government Report No. 54/2017 to the State Parliament of the Principality of Liechtenstein regarding the approval of a supplementary credit to ensure basic care in the Liechtenstein State Hospital, p. 42.
  64. ↑ Point 2.5 Performance mandate Liechtensteinisches Landesspital of March 18, 2008. See also Point 2.6 Performance mandate Liechtensteinisches Landesspital of March 18, 2008.
  65. ^ Liechtensteiner Volksblatt of October 1, 2017
  66. ↑ LGBl. 240/1999. However, the Health Act (GesG) of December 13, 2007, in accordance with Art 37 para. 3 GesG, does not apply. LGBl. 30/2008.
  67. ↑ Art 1a LLSG.
  68. ↑ BSchG, LGBl 139/2007.
  69. ↑ Point 2.6 Performance mandate of the Liechtenstein State Hospital of March 18, 2008.
  70. ↑ Government and Administration Organization Ordinance (RVOV) of March 28, 2013, LGBl. 163/2013.
  71. ↑ See also Art. 5 Statutes of the State Hospital.
  72. ↑ Art 5 para. 2 LLSG.
  73. ↑ Art 5 para. 3 LLSG.
  74. ↑ Budget according to the Finance Act of 7 November 2013 for 2014, LGBl. 377/2013.
  75. ↑ Art. 5 of the law of November 20, 2009 regarding the amendment of the law on the Liechtenstein State Hospital, LGBl. 370/2009.
  76. ↑ The in-house newspaper is online from No. 50 (November 2014) and the annual reports are available from 2012.