Meinhardt M, Plamper E, Brunner H
Universität zu Köln, Köln, BRD.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2009 Jan;52(1):96-103. doi: 10.1007/s00103-009-0754-3.
The GMG (Law Modernizing the German Health Care System) was introduced in 2004. It resulted in considerable changes concerning the possibility for patients to participate in decisions in the German health care system. For the first time representatives of patients in the restructured Federal Joint Committee (G-BA), elected by patients and patient-organizations, were institutionalized by law. In later legislation, this route was further pursued: GKV-WSG and the VAndG of 2007. A previous quantitative study performed by the Institute for Health Economics and Clinical Epidemiology of the University of Cologne in 2006 provided some information on the degree of the involvement of patient representatives in the decision-making process of the G-BA. The present study is an attempt to extend this information by further in-depth interviews. The qualitative interviews of patient representatives in the G-BA unravelled a basic need for improvement of their financial and structural resources. This would lead to consequences in nearly all areas of patient participation--beginning with the quality of the patient representatives' contributions, the role within the G-BA and subsequently their role in public relations. It can be concluded that health politicians can be influenced only gradually in a process of permanent discussions on these issues.
《德国医疗体系现代化法案》(GMG)于2004年出台。它给德国医疗体系中患者参与决策的可能性带来了重大变革。患者代表首次在由患者和患者组织选举产生的重组后的联邦联合委员会(G-BA)中得以依法制度化。在后来的立法中,这一途径得到了进一步推进:2007年的《法定医疗保险结构改革法》(GKV-WSG)和《患者参与法》(VAndG)。科隆大学卫生经济与临床流行病学研究所在2006年进行的一项前期定量研究提供了一些关于患者代表参与G-BA决策过程程度的信息。本研究试图通过进一步深入访谈来拓展这些信息。对G-BA中患者代表的定性访谈揭示了改善其财务和结构资源的基本需求。这将在患者参与的几乎所有领域产生影响——从患者代表贡献的质量、在G-BA中的角色,到随后在公共关系中的角色。可以得出结论,在就这些问题进行的持续讨论过程中,只能逐步影响卫生政策制定者。