Preisbildung bei ambulant und stationär erbrachten Gesundheitsleistungen / Pricing of Ambulatory and Stationary Health Services

2007 ◽  
Vol 227 (5-6) ◽  
Author(s):  
Günter Neubauer ◽  
Florian Pfister

SummaryIn all health care systems exists governmental regulation, as the market for health is unanimously regarded as imperfect. The German health care market is a good example for a strongly regulated market in nearly each submarket, partially the determination of prices. Reimbursement of health goods and services is overwhelmingly collectively contracted between the health insurers and healthcare providers. In this article, we begin with the description of central functions of prices in the health care sector and components of reimbursement systems. After the general thoughts follows an overview of the concrete reimbursement reality in Germany’s ambulatory and stationary care. We identify and discuss pro and contra the trend towards single prices for identical health services in all of Germany. Another, in someway opposite, trend is less collective bargaining between health insurers and associations of health providers, which gets increasingly substituted with selective contracting. Another issue we cover is the relationship between price competition and quality competition.

2002 ◽  
Vol 60 (2) ◽  
pp. 103-107 ◽  
Author(s):  
Lisa Bøge Christensen ◽  
Poul Erik Petersen ◽  
Annelise Bastholm ◽  
Lone Laurberg

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lilian Keene Boye ◽  
Christian Backer Mogensen ◽  
Tine Mechlenborg ◽  
Frans Boch Waldorff ◽  
Pernille Tanggaard Andersen

Abstract Background Half of the older persons in high-income counties are affected with multimorbidity and the prevalence increases with older age. To cope with both the complexity of multimorbidity and the ageing population health care systems needs to adapt to the aging population and improve the coordination of long-term services. The objectives of this review were to synthezise how older people with multimorbidity experiences integrations of health care services and to identify barriers towards continuity of care when multimorbid. Methods A systematic literature search was conducted in February 2018 by in Scopus, Embase, Cinahl, and Medline using the PRISMA guidelines. Inclusion criteria: studies exploring patients’ point of view, ≥65 and multi-morbid. Quality assessment was conducted using COREQ. Thematic synthesis was done. Results Two thousand thirty studies were identified, with 75 studies eligible for full text, resulting in 9 included articles, of generally accepted quality. Integration of health care services was successful when the patients felt listened to on all the aspects of being individuals with multimorbidity and when they obtained help from a care coordinator to prioritize their appointments. However, they felt frustrated when they did not have easy access to their health providers, when they were not listened to, and when they felt they were discharged too early. These frustrations were also identified as barriers to continuity of care. Conclusions Health care systems needs to adapt to people with multimorbidity and find solutions on ways to create flexible systems that are able to help older patients with multimorbidity, meet their individual needs and their desire to be involved in decisions regarding their care. A Care coordinator may be a solution.


1992 ◽  
Vol 22 (3) ◽  
pp. 513-528 ◽  
Author(s):  
T. K. Sundari

This article attempts to put together evidence from maternal mortality studies in developing countries of how an inadequate health care system characterized by misplaced priorities contributes to high maternal mortality rates. Inaccessibility of essential health information to the women most affected, and the physical as well as economic and sociocultural distance separating health services from the vast majority of women, are only part of the problem. Even when the woman reaches a health facility, there are a number of obstacles to her receiving adequate and appropriate care. These are a result of failures in the health services delivery system: the lack of minimal life-saving equipment at the first referral level; the lack of equipment, personnel, and know-how even in referral hospitals; and worst of all, faulty patient management. Prevention of maternal deaths requires fundamental changes not only in resource allocation, but in the very structures of health services delivery. These will have to be fought for as part of a wider struggle for equity and social justice.


2014 ◽  
Vol 3 (6) ◽  
pp. 56 ◽  
Author(s):  
Camilla Lauritzen

This article addresses the issue of parental mental illness. The theoretical background and rationale for developing new routines to change clinical practice is described, suggesting a policy change in which a child focus is implemented in adult mental health services. Furthermore, proposed strategies that have the potential of being effective within existing health care systems are discussed.


2017 ◽  
Vol 36 (4) ◽  
pp. 33-67 ◽  
Author(s):  
Nick Kates

For 20 years mental health and primary care providers across Canada have been working collaboratively together to improve access to care, provider skills, and patient experience. The new strategic plan of the Mental Health Commission of Canada (MHCC) offers many opportunities for collaborative care to play a role in the transformation of Canada’s mental health systems. To assist the plan, this paper presents principles underlying successful projects and ways that mental health and primary care services can work together more collaboratively, including integrating mental health providers in primary care. It integrates these concepts into a Canadian Model for Collaborative Mental Health Care that can guide future expansion of these approaches, and suggests ways in which better collaboration can address wider issues facing all of Canada’s health care systems.


1989 ◽  
Vol 18 (2) ◽  
pp. 235-251 ◽  
Author(s):  
Cam Donaldson ◽  
Karen Gerard

ABSTRACTWithin both publicly and privately financed health care Systems different funding mechanisms have evolved, or have been proposed, to deal with the problem of ‘moral hazard’. Moral hazard arises when financial incentives within the health care System lead to either inefficient demands for care by consumers or inefficient supply of care by providers. In this paper the problem of moral hazard is outlined in more detail, and different ways of countering moral hazard are reviewed in terms of three criteria: effect on patient utilisation of health services in general; effect on utilisation by different groups of patients; and effect on health status. It is concluded that evidence on different methods of funding health services can only be judged in the context of objectives. If the objectives of health care delivery are ‘maintenance or improvement of health’ and ‘equal access for equal need’ then charges and finance of care through health maintenance organisations both appear to be less favourable than ‘free’ care at the point of delivery whilst the latter is not necessarily more costly as a resuit. Research on other suggested alternatives is required, otherwise radical changes to health care financing in the UK will simply result in movement from one unproven system to another.


2016 ◽  
Vol 47 (2) ◽  
pp. 333-351 ◽  
Author(s):  
Paul Barker ◽  
John Church

Twenty years ago, many of Canada’s provinces began to introduce regional health authorities to address problems with their health care systems. With this action, the provinces sought to achieve advances in community decision-making, the integration of health services, and the provision of care in the home and community. The authorities were also to help restrict health care costs. An assessment of the authorities indicates, however, that over the past two decades they have been unable to meet their objectives. Community representatives continue to play little role in determining the appropriate health services for their regions. Gains have been made towards integrating health services, but the plan for a near seamless set of health services has not been realized. Funding for health services remains focused on hospital and physician care, and health care expenditures have until very recently been little affected by regional authorities. This disappointing performance has caused some provinces to abandon their regional authorities, but this article argues that the provision of greater autonomy and a better public appreciation of their role and potential may lead to more successful regional authorities. Accordingly, the objective of this article is to reveal the shortcomings of regional health authorities in Canada while at the same time arguing that changes can be made to increase the chances of more workable authorities.


2011 ◽  
pp. 57-64
Author(s):  
Daniel Carbone

A lack of health services has long been the thorn in the side of many communities, especially rural and regional communities. The high costs of treating ever growing chronic and complex conditions in traditional settings, where rural allied health services providers are non-existent and doctors are already overcommitted, are prompting a shift in focus to more efficient technology driven delivery of health services. Moreover, these days it is also increasingly unlikely that health professionals will encounter patients who have not used information technology to influence their health knowledge, health behaviour, perception of symptoms, and illness behaviour. Advances in Internet technologies offer promise towards the development of an e-health care system. This article will postulate whether portal technologies can play a role facilitating the transition to such e-health care systems. This article aims at reviewing the literature to present to the reader the barriers and opportunities out here for effective health portals. However, the article does not intend to provide a one-fits-all technical/content solution, only to make implementers and developers aware of the potential implications.


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