Büyükdurmus Tugba, Kopetsch Thomas, Schmitz Hendrik, Tauchmann Harald
Universität Duisburg-Essen, Essen, Germany.
CINCH - National Research Center for Health Economics, Essen, Germany.
Health Econ Rev. 2017 Dec;7(1):2. doi: 10.1186/s13561-016-0132-4. Epub 2017 Jan 17.
For some considerable time now the interface between ambulatory and hospital care has been mooted as a cause of inefficiencies in the German health system and there have been calls for a softening of the strict separation between the two sectors. This debate emphasizes the need for detailed empirical information on the interdependence between the two sectors. Using extensive administrative data at the level of the 412 German counties for the years 2007 to 2009 and a simultaneous equation model which allows the numbers of ambulatory and hospital cases to be mutually interdependent, we examine the connection between ambulatory and hospital specialist care separately for ten medical specialties. The results show that the interdependence of ambulatory and hospital services is far from homogeneous. The relationship depends, on the one hand, on the specialty and, on the other, on the direction of the effect observed. This heterogeneity needs to be taken into account for cross-sector needs-based planning.
一段时间以来，门诊护理与医院护理之间的衔接一直被认为是德国医疗体系效率低下的一个原因，并且一直有人呼吁放宽这两个部门之间的严格分离。这场辩论强调了获取有关这两个部门相互依存关系的详细实证信息的必要性。我们利用2007年至2009年德国412个县层面的大量行政数据以及一个允许门诊病例数和住院病例数相互依存的联立方程模型，分别针对十个医学专科研究门诊护理与医院专科护理之间的联系。结果表明，门诊服务与住院服务之间的相互依存关系远非同质化。这种关系一方面取决于专科，另一方面取决于所观察到的影响方向。在跨部门基于需求的规划中需要考虑到这种异质性。
