Baumgarten J
Acta Hosp. 1988;28(3):67-73.
Acta Hospitalia publishes this summary as an illustration of the difficult process most Western countries experience in reorienting their hospital financing systems. The case of West-Germany is of particular interest. It is the leading economic power in the European Economic Community and its sickness funds (the Krankenkassen) play a very important role in hospital financing. The article reports on the conclusions of a five year study by the R. Bosch Stiftung. We draw attention to the following: The article illustrates that each hospital financing system implies a particul balance of power between the hospitals, on the one hand, and the sickness funds on the other hand, under the auspices of the government. The final balance of power is not so much determined by the general principles but by the detailed operational procedures on which the financing system will eventually be based. This may explain why the conclusions of the Commission are rather vague. The option of the price as the main control instrument immediately demands some 'state committee' to lay down the guidelines for the provision of hospital care including the regional conditions and minimum service quantity and quality standards.
《医院学报》发表此摘要，以说明大多数西方国家在重新调整其医院融资体系时所经历的艰难过程。西德的情况尤其令人关注。它是欧洲经济共同体的主要经济强国，其疾病基金（法定医疗保险公司）在医院融资中发挥着非常重要的作用。本文报道了罗伯特·博世基金会为期五年的研究结论。我们提请注意以下几点：本文表明，每个医院融资体系都意味着在政府的支持下，医院与疾病基金之间存在一种特定的权力平衡。最终的权力平衡与其说是由一般原则决定的，不如说是由融资体系最终所依据的详细操作程序决定的。这或许可以解释为什么委员会的结论相当模糊。将价格作为主要控制手段的选择立即要求某个“国家委员会”制定医院护理提供的指导方针，包括地区条件以及最低服务数量和质量标准。
