Mennicken Roman, Kolodziej Ingo W K, Augurzky Boris, Kreienberg Rolf
Landschaftsverband Rheinland, Cologne, Germany.
Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Essen, Germany; Ruhr-University Bochum, Germany.
Health Policy. 2014 Dec;118(3):396-406. doi: 10.1016/j.healthpol.2014.07.017. Epub 2014 Aug 2.
Financial soundness will become more and more difficult in the future for all types of hospitals. This is particularly relevant for gynaecology and obstetrics departments: while some disciplines can expect higher demand due to demographic changes and progress in medicine and medical technology, the inpatient sector for gynaecology and obstetrics is likely to lose patients in line with these trends. In this paper we estimate future demand for gynaecology and obstetrics in Germany and develop a cost model to calculate the average profitability in this discipline. The number of inpatient cases in gynaecology and obstetrics can be expected to decrease by 3.62% between 2007 and 2020 due to the demographic change and a potential shift from inpatient to outpatient services. Small departments within the fields of gynaecology and obstetrics are already incurring heavy losses, and the anticipated decline in cases should increase this financial distress even more. As such, the further centralisation of services is indicated. We calculate travel times for gynaecology and obstetrics patients and estimate the anticipated changes in travel times by simulating different scenarios for this centralisation process. Our results show that the centralisation of hospital services in gynaecology and obstetrics may be possible without compromising comprehensive access as measured by travel times.
未来，各类医院的财务稳健性将变得越来越困难。这一点在妇产科部门尤为突出：虽然由于人口结构变化以及医学和医疗技术的进步，一些学科预计需求会增加，但妇产科的住院业务可能会随着这些趋势而流失患者。在本文中，我们估算了德国未来对妇产科的需求，并开发了一个成本模型来计算该学科的平均盈利能力。由于人口结构变化以及住院服务向门诊服务的潜在转变，预计2007年至2020年间妇产科的住院病例数将减少3.62%。妇产科领域内的小科室已经出现了严重亏损，而预计病例数的下降将进一步加剧这种财务困境。因此，有必要进一步集中服务。我们计算了妇产科患者的出行时间，并通过模拟该集中化过程的不同情景来估算出行时间的预期变化。我们的结果表明，妇产科医院服务的集中化在不影响以出行时间衡量的全面可及性的情况下是可行的。
