In spite of numerous discussions and programs aimed at reducing public health care costs in Germany, the country has seen a massive increase in health care costs at an annual average rate of 7% since 1972. When
These actions will be divided into strategic and organizational-operational actions, which have a direct implication on the DRG system or conterminal areas. The strategic actions should provide a first step toward developing a comprehensive system under which individual hospitals can determine the best set of actions to reach their respective goals. The organizational-operative dimension then focuses on the concrete individual actions a hospital can take to reach that goal. RESULTS UND CONCLUSION: As a result, this analysis reveals that hospitals should increasingly attempt to find additional sources of income outside the closed-ended sectoral budgets of the public health insurance sector in Germany. Further, hospitals should increasingly focus on optimizing their cost structure according to standard optimization approaches to increase their ability to provide quality services at competitive costs. Finding the right size for each hospital under the new DRG incentivation and compensation structure has become one of the most critical strategic questions each hospital has to answer individually.
Quo vadis health-care system? Finding a definite answer to that question is as difficult as settling the conflict between Israel and the Palestinians. Many scientists, politicians, associations and lobbyists comment on their most recent findings and offer their opinions on a daily basis. The author Petra Strodtholz joins that illustrious group and describes her point of view from a social scientist's perspective.Strodtholz defines an underlying theoretical framework encompassing approaches like the policy research field and the sociological system theory using control theory as her starting point. This starting point defines the boundaries within which she evaluates recent reforms and analyzes potential future developments and options.The book is subdivided into two major parts. The first part comprises a description of cost-containment efforts in Germany and Europe in the 1990s. The second part deals with newer developments such as structural changes with a focus on efficiency and the enforcement of competitive elements in the German and European health-care systems. In this part she also lays out future options for the development of the overall system. Later on she divides these future options into the main categories for which decisions should be made: equal opportunity to access the health-care system, fairness in financing and distribution, cost efficiency, effectiveness of medical treatment and its necessity and adequacy in individual cases.The overall structure of the book appears somewhat confusing, and this makes it sometimes difficult to pick up the thread. Overall readability could have been improved by an illustration or summary in the subchapters. However, the topics covered offer an enormous store of national and international cross-references, which is the main strength of the publication. The publication summarizes recent developments in a European context and addresses readers who are interested in an overview of the dynamics of the health-care system.
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