Wich Michael, Auhuber Thomas, Scholtysik Dirk, Ekkernkamp Axel
BG Klinikum Unfallkrankenhaus Berlin gGmbH, Achenbach-Krankenhaus Königs Wusterhausen, Alice Salomon Hochschule Berlin, Deutschland.
BG Klinikum Unfallkrankenhaus Berlin gGmbH, Hochschule der Deutschen Gesetzlichen Unfallversicherung (HGU), Deutschland.
Z Evid Fortbild Qual Gesundhwes. 2018 Feb;130:13-20. doi: 10.1016/j.zefq.2017.07.009. Epub 2017 Sep 1.
In the mid-1920s Porter and others developed a reform approach for existing health care systems, aiming at a patient-focused, value-based orientation. Improving patient outcomes by attaining, preserving and restoring good health is inherently less costly than dealing with poor health. The authors of the present article will outline that the German statutory accident insurance system, which was already introduced in1884 and is of an evolving nature, reflects key elements of Porter's efficient value-based health care system. The German accident insurance system with its statutory mandate limited to the prevention and rehabilitation of work-related damage to one's health can also serve as a model for other larger health care insurance systems. Prevention and rehabilitation is pursued using all appropriate means to achieve the set goals of protecting and restoring individual health. In line with these objectives, the statutory health insurance controls the process in terms of the required care quality. The components of a complex health care system, usually managed by a variety of different institutions, are consolidated. Thus it can be ensured that in both prevention and rehabilitation all services that are necessary to keep focussing the value "individual health" rather than indemnities are applied.
20世纪20年代中期，波特等人针对现有的医疗保健系统提出了一种改革方法，旨在以患者为中心，以价值为导向。通过实现、保持和恢复良好健康状况来改善患者预后，本质上比处理健康不佳的情况成本更低。本文作者将概述德国法定事故保险制度，该制度于1884年已引入且具有不断发展的性质，体现了波特高效的基于价值的医疗保健系统的关键要素。德国事故保险制度的法定任务仅限于预防和康复与工作相关的健康损害，它也可以成为其他更大的医疗保险系统的典范。利用一切适当手段进行预防和康复，以实现保护和恢复个人健康的既定目标。根据这些目标，法定健康保险在所需护理质量方面控制这一过程。一个通常由各种不同机构管理的复杂医疗保健系统的各个组成部分得到整合。这样可以确保在预防和康复过程中，应用所有必要的服务，以始终关注“个人健康”这一价值而非赔偿金。
