Schwartz F W
Abteilung Epidemiologie und Sozialmedizin, Medizinische Hochschule, Hannover.
Gesundheitswesen. 1992 Sep;54(9):443-50.
The German health care system is currently faced with challenges that stem from the changing demographic structure of the population as well as from the increasing implementation of costly technological advances in diagnosis and treatment in the presence of inadequate preventive and rehabilitative structures. Ever-rising expectations and demands on the part of German citizens and the increasing number of doctors are threatening to overburden the increasingly limited financial resources of the health care system. The pressure for allocatory measures has led to intense competition amongst the various specialties and sectors of the health care system. In this paper the author describes the current developments with regard to the evolution of the health care system in the near future. He predicts an increasing demand for long-term care facilities especially for the elderly, for more easily accessible rehabilitative services as well as a continuing increasing demand for high-tech services. The pressure of these qualitative as well as quantitative demands in the face of intersectoral competition and limited financial resources will necessarily lead to a restructuring of the professional as well as non-professional system with new forms of organization for in-patient as well as out-patient services that will address these issues.
德国医疗保健系统目前面临着诸多挑战，这些挑战源于人口结构的不断变化，以及在预防和康复结构不完善的情况下，诊断和治疗方面昂贵技术进步的日益普及。德国公民不断提高的期望和要求，以及医生数量的增加，正威胁着使医疗保健系统日益有限的财政资源不堪重负。分配措施的压力导致了医疗保健系统各专业和部门之间的激烈竞争。在本文中，作者描述了医疗保健系统在不久的将来的当前发展情况。他预测，对长期护理设施，尤其是对老年人的长期护理设施的需求将不断增加，对更容易获得的康复服务的需求也将增加，对高科技服务的需求也将持续增长。面对部门间竞争和有限的财政资源，这些质量和数量需求的压力必然会导致专业和非专业系统的重组，以及住院和门诊服务新组织形式的出现，以解决这些问题。
