König H H, Seitz R
Universität Ulm, Abteilung Gesundheitsökonomie.
Gesundheitswesen. 1999 Jun;61(6):274-9.
This article deals with the transferability of managed care strategies to the German health care system. First of all, a definition of managed care and its characteristic strategies is presented. Secondly, the legal basis as defined by the German social code for the implementation of managed care strategies is examined. Focusing on the ambulatory care sector, possible positive and negative effects of these strategies are assessed. It shows that managed care strategies are not unknown to the German health care system. Especially the 1997 health care reform law increased the opportunities for implementation of managed care strategies on a voluntary basis. However, for a structural reform of the statutory health insurance system based on the principles of managed care, both the legal basis and the sociopolitical acceptance are still lacking.
本文探讨了管理式医疗策略在德国医疗体系中的可转移性。首先,给出了管理式医疗及其特色策略的定义。其次,研究了德国社会法典所定义的实施管理式医疗策略的法律基础。聚焦于门诊护理领域,评估了这些策略可能产生的积极和消极影响。结果表明,德国医疗体系对管理式医疗策略并不陌生。特别是1997年的医疗改革法增加了自愿实施管理式医疗策略的机会。然而,要基于管理式医疗原则对法定医疗保险体系进行结构性改革,法律基础和社会政治认可度仍然欠缺。