Neugebauer Edmund, Piwernetz Klaus, Bramesfeld Anke, Deckert Stefanie, Falkai Peter, Gabrys Lars, Hollederer Alfons, Riedel-Heller Steffi G, Schaller Andrea, Scheibe Madlen, Bierbaum Thomas, Schmitt Jochen, Dreinhöfer Karsten E
Medizinische Hochschule Brandenburg (MHB), Theodor Fontane Neuruppin, Germany.
Public Health, Medimaxx Health Management GmbH, München, Germany.
Gesundheitswesen. 2022 Oct;84(10):971-978. doi: 10.1055/a-1911-8605. Epub 2022 Sep 6.
Goals for health and health care are an indispensable basic requirement for a functioning health care system. The dilemma of the German health care system is that it has not been designed in a planned way, but that it has grown historically. In recent years, it has developed through the free play of forces into what it is today. The OECD characterizes the current state as follows: The costs of the German health system do not correspond to the often only average health outcomes for the population. To meet the legal requirements (especially SGB V §§ 12, 27 and 70), health care/the health system in Germany needs concrete goals. An orientation towards health care goals entails measures on all levels of health care: on the macro level (overall system/total population), on the meso level (subdivided according to regions, specific population groups, etc.) as well as on the micro level (patients and health care providers). Based on national and international experiences, this position paper of the DNVF e.V. (German Network for health services research) shows the potential of how operationalised health care targets can ensure effective, affordable and high-quality health care. The coalition agreement of the current government propagates a reorientation with patient-related health care goals. Now it is important to derive concrete and realisable goals from this declaration of intent and to involve all important groups in the process. In addition, values and ethical standards for implementation shall be agreed upon in this process. The Health Ministry (BMG) should facilitate and promote the process of societal will-building for the definition of national health care goals. This requires a clear political will. As a result, the National Health Care Goals are available at the end of the process, which are published and maintained together with evidence-based facts as well as valid and resilient data in a Manual "National Health Care Goals". The operational responsibility for implementation could lie with the newly to be founded Federal Institute of Public Health, as already announced in the agreement of the governing coalition. The DNVF is willing to actively participate in the development of health care targets.
健康及医疗保健目标是一个运转良好的医疗保健系统不可或缺的基本要求。德国医疗保健系统的困境在于，它并非以规划的方式设计而成，而是在历史进程中逐渐发展起来的。近年来，它通过各种力量的自由博弈演变成了如今的模样。经济合作与发展组织（OECD）对当前状况的描述如下：德国医疗系统的成本与民众往往仅处于平均水平的健康结果并不匹配。为满足法律要求（特别是《社会法典》第五编第12条、第27条和第70条），德国的医疗保健/医疗系统需要具体的目标。以医疗保健目标为导向意味着在医疗保健的各个层面采取措施：宏观层面（整个系统/全体人口）、中观层面（按地区、特定人群等细分）以及微观层面（患者和医疗服务提供者）。基于国内和国际经验，德国卫生服务研究网络（DNVF e.V.）的这份立场文件展示了将医疗保健目标具体化如何能够确保有效、可负担且高质量的医疗保健。现任政府的联盟协议倡导以与患者相关的医疗保健目标为导向进行重新定位。现在，重要的是从这一意向声明中推导出具体且可实现的目标，并让所有重要群体参与到这一过程中。此外，在此过程中还应就实施的价值观和道德标准达成一致。卫生部（BMG）应推动并促进为确定国家医疗保健目标而进行的社会意愿构建过程。这需要明确的政治意愿。最终会形成国家医疗保健目标，这些目标将与基于证据的事实以及有效且可靠的数据一同在一本《国家医疗保健目标手册》中发布并持续更新。正如执政联盟协议中已宣布的那样，实施的运营责任可能由新成立的联邦公共卫生研究所承担。德国卫生服务研究网络（DNVF）愿意积极参与医疗保健目标的制定。
