Abstract:
The introduction of the DRG system in 2003/04 can be considered the last real hospital reform. Although the latest reform was called Hospital Structure Act due to its insufficient structural components it is sometimes referred to as missed reform. Essential aspects of the institutional background remained unchanged. However, a closer look reveals even the introduction of the DRG system was only a change in the reimbursement of operating costs. Further structural changes were neither discussed nor induced. The same applies to all subsequent reforms. The key parameters of the regulatory framework are for the greater part the same as those established by the German Hospital Finance Act in 1972. Against this backdrop, the presented paper discusses the institutional background and potential reasons for its continuance. The focus is on the question, whether missed reforms are based on its optimality or which alternative explanations seem to be convincing.
VOLUNTARY HOSPITAL FINANCE
