Challenges for the German Health Care System

Abstract

The German Health Care System (GHCS) faces many challenges among which an aging population and economic problems are just a few. The GHCS traditionally emphasised equity, universal coverage, ready access, free choice, high numbers of providers and technological equipment; however, real competition among health-care providers and insurance companies is lacking. Mainly in response to demographic changes and economic challenges, health-care reforms have focused on cost containment and to a lesser degree also quality issues. In contrast, generational accounting, priorisation and rationing issues have thus far been completely neglected. The paper discusses three important areas of health care in Germany, namely the funding process, hospital management and ambulatory care, with a focus on cost control mechanisms and quality improving measures as the variables of interest. Health Information Technology (HIT) has been identified as an important quality improvement tool. Health Indicators have been introduced as possible instruments for the priorisation debate.

Zusammenfassung

In der vorliegenden Arbeit werden Grundzüge des Deutschen Gesundheitssystems dargelegt. Diskutiert werden Finanzierung (Funding) und Besonderheiten des Krankenhaus- und ambulanten Sektors unter Kosten- und Qualitätsaspekten. Lösungsansätze beinhalten die Einführung und Verbesserung von Gesundheitsinformationstechnologie (Health Information Technology, HIT). Einen Überblick in deutscher Sprache gibt das im gleichen Heft abgedruckte Editorial. Ein besseres Verständnis des aktuellen Gesundheitssystems möge dem gastroenterologisch tätigen Arzt das Rüstzeug geben, sich im Spannungsfeld politischer, juristischer, gesellschaftlicher und philosophisch-ethischer Fragestellungen besser zurechtzufinden. Ziel ist es, eine konstruktive Diskussion zu fördern und aktiv das Gesundheitssystem zu gestalten.

Key words

aging population - pharmacoecnomics - hospital - ambulatory care - health information technology - priorisation

Schlüsselwörter

Alterspyramide - Pharmaökonomie - Krankenhaus - ambulanter Sektor - Gesundheit - Informationstechnologie - Priorisierung

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