Minz Rainer, Grüttner Damian, von Heusinger-Lender Marlis
Aufsichtsrat, Universitätsklinikum Köln (AöR), Köln, Deutschland.
Vorstand, Universitätsklinikum Köln (AöR), Köln, Deutschland.
Gefasschirurgie. 2023;28(2):98-107. doi: 10.1007/s00772-023-00986-6. Epub 2023 Mar 10.
Over the past 30 years the number of hospitals in Germany has fallen by 21% and the number of hospital beds by 27%. During the same period the average length of stay in hospitals has halved. Nevertheless, the system efficiency is too low.
The causes of the system inefficiency in the German hospital sector and approaches for a hospital reform are presented.
The official statistics were analyzed and a summary of fundamental works, studies and expert recommendations is given in a review article.
The regulatory coexistence of hospital planning and hospital financing leads to a structural underfunding of hospitals and to a suboptimal supply with hospital services. The purely inpatient-oriented remuneration system conserves inpatient forms of treatment. In an international comparison there is a high hospital density in Germany. This intensifies the shortage of specialist personnel in healthcare professions. In addition, the level of digitalization in German hospitals is too low.
A reduction of the number of hospitals in conjunction with increased specialization can increase the quality of hospital treatment for the patients and also increase the effectiveness of the deployment of scarce specialist personnel. There is a need for a differentiated financing concept according to treatment levels. An increase in the attractiveness of specialist healthcare professions, particularly by improvement of the training can counteract the shortage of specialist personnel. The hospital system must catch up with digitalization in order to be able to provide up to date equipped workplaces and modern organized work processes and also to improve the economic efficiency.
在过去30年里，德国医院数量减少了21%，病床数量减少了27%。同期，医院平均住院时长减半。然而，系统效率仍然过低。
阐述德国医院部门系统效率低下的原因以及医院改革的方法。
分析官方统计数据，并在一篇综述文章中总结基础著作、研究和专家建议。
医院规划与医院融资的监管并存导致医院结构性资金不足，医院服务供应未达最优。纯粹以住院治疗为导向的薪酬体系保留了住院治疗形式。在国际比较中，德国医院密度较高。这加剧了医疗保健专业专科人才的短缺。此外，德国医院的数字化水平过低。
减少医院数量并提高专业化程度可以提高患者的医院治疗质量，还能提高稀缺专科人才的使用效率。需要根据治疗水平制定差异化的融资概念。提高专科医疗保健专业的吸引力，尤其是通过改善培训，可以抵消专科人才短缺的问题。医院系统必须跟上数字化步伐，以便能够提供配备最新设备的工作场所和现代化的组织工作流程，同时提高经济效率。
