Nagel Eckhard, Alber Kathrin, Bayerl Birgitta
Universität Bayreuth, Institut for Medizinmanagement und GEsundheitswissenschaften, Bayreuth.
Z Evid Fortbild Qual Gesundhwes. 2010;104(5):355-9. doi: 10.1016/j.zefq.2010.06.002. Epub 2010 Aug 7.
Complex developments are increasing the gap between the financial feasibility of the German health care system and new possibilities in diagnosis and therapy. Influencing factors, inter alia, include rapid medical progress, demographic and epidemiological trends and changing perceptions of health and illness. This raises the question of how a just allocation of scarce resources can be developed and implemented. Concepts such as rationalisation, rationing and prioritisation are being intensively discussed. In this paper definitions of and differentiations between these terms will be presented, which are often missing from the current debate. Furthermore, the need for action implying ethical and structural-political challenges will be outlined. In this regard, a sustainable process should focus on transparency, responsibility and public involvement.
复杂的发展正在加大德国医疗保健系统财务可行性与诊断和治疗新可能性之间的差距。影响因素尤其包括医学的快速进步、人口统计学和流行病学趋势以及对健康与疾病认知的变化。这就引发了一个问题，即如何制定并实施稀缺资源的合理分配。诸如合理化、配给和优先级排序等概念正在被深入讨论。本文将给出这些术语的定义及区分，而当前的辩论中往往缺少这些内容。此外，还将概述意味着伦理和结构政治挑战的行动必要性。在这方面，一个可持续的过程应注重透明度、责任和公众参与。
