Hahn U, Kretz F, Awe B, Koch J
OcuNet Verwaltungs GmbH, Tannenstr. 37, 40476, Düsseldorf, Deutschland.
Augenärzte Gerl, Kretz & Kollegen, Ahaus, Deutschland.
Ophthalmologe. 2018 May;115(5):400-408. doi: 10.1007/s00347-017-0525-8.
The aim of the study was to evaluate the contribution to outpatient care and the perspectives of employed and self-employed ophthalmologists in isolation and in comparison to other professional groups.
Based on statistical data (source: statistical information provided by the National Association of Statutory Health Insurance Physicians) from 31 December 2015, newly admitted physicians in 2015 and their contribution differentiated by employment relationships were evaluated according to head count and working time equivalents (using "planning of demand equivalents"). The results were subdivided into type of outpatient facility, e.g. single practice, group practice and medical care centers (MVZ).
The proportion of employed ophthalmologists (head count) in outpatient care (23%) and newly admitted physicians (81%) is above the interdisciplinary average (16% and 65%, respectively). In all medical professional groups the contribution according to time equivalents of employed physicians compared to self-employed physicians is lower (utilization rate: 65% in total and 70% in ophthalmology). In ophthalmology employment is seen in all types of outpatient practices: the number of ophthalmologists working in group practices is above average, compared to other groups they are underrepresented in MVZ and are working in single practices as frequently as all other specialties.
Employment of physicians is more common in all types of outpatient ophthalmological facilities than in other specialized professional groups. Possible reasons are the working conditions in ophthalmology attracting physicians preferring employment and the competitive situation for practice takeover. Since employed physicians contribute less time to medical care than self-employed physicians, ophthalmology has a higher risk of a shortage in medical care despite an increasing number of physicians. An increasing number of employed physicians has an impact on the structures of outpatient care; however, the intensity of concentration in healthcare structures can only be partially evaluated due to insufficient data. Based on the available data there is no end in sight for the trend towards employment in outpatient ophthalmological care.
本研究旨在评估受雇眼科医生和个体开业眼科医生对门诊护理的贡献，以及他们与其他专业群体相比的情况和观点。
基于2015年12月31日的统计数据（来源：法定医疗保险医师全国协会提供的统计信息），对2015年新入职医生及其按雇佣关系区分的贡献，按人数和工作时间当量（使用“需求当量规划”）进行评估。结果按门诊机构类型细分，如个体诊所、联合诊所和医疗护理中心（MVZ）。
受雇眼科医生在门诊护理中的比例（人数）（23%）和新入职医生中的比例（81%）高于跨学科平均水平（分别为16%和65%）。在所有医学专业群体中，受雇医生按时间当量计算的贡献与个体开业医生相比更低（利用率：总体为65%，眼科为70%）。在眼科领域，各类门诊业务中均存在受雇情况：联合诊所工作的眼科医生数量高于平均水平，与其他群体相比，他们在医疗护理中心的占比不足，在个体诊所工作的频率与所有其他专科相同。
在各类门诊眼科机构中，医生受雇情况比其他专业群体更为普遍。可能的原因是眼科的工作条件吸引了倾向于受雇的医生，以及诊所收购的竞争状况。由于受雇医生用于医疗护理的时间比个体开业医生少，尽管医生数量不断增加，但眼科医疗护理短缺的风险更高。受雇医生数量的增加对门诊护理结构产生影响；然而，由于数据不足，只能部分评估医疗保健结构中的集中强度。根据现有数据，门诊眼科护理的受雇趋势看不到尽头。
