[Dealing with bottlenecks in health care: the hospital management perspective].

After the introduction of diagnosis related groups (DRGs) in Germany for the remuneration of hospitals economic aspects have become increasingly daunting. While hospitals were used to being paid on a daily basis they are now provided with a fixed sum for a given diagnosis. This means that hospitals are under pressure to review their processes and to treat more patients during shorter hospital stays. In order to contain costs the quality of treatment and care has to be improved since poor quality, i.e. the development of complications, would cause higher costs. This has led to 25% of the 2,200 hospitals in Germany running deficits, which is reflected in a shortage of doctors and nurses as well as in a lack of adequately advanced medical equipment and suitable hospital buildings. These facts pose an enormous challenge to the hospital management: they have to bridge the gap between economic requirements and the patients' needs. This is why hospital management needs to develop visions and strategies as well as a tight financial and medical controlling and steering system to improve their financial and medical outcomes.