[Descriptive analysis of the steering potential in the internal medicine in Germany based on an international comparison].

BACKGROUND

Healthcare in Germany is not always needs-based and has considerable potential for optimization. Internal medicine (IM) plays a special role in the German healthcare system due to its long tradition. Against this background, a look at the optimization potential to achieve better quality and higher efficiency care seems particularly relevant.

OBJECTIVE

Based on an international comparison and taking ambulatory care-sensitive conditions (ACSC) into account, this study aims to identify the steering potential in IM and to discuss it in the context of current reform plans.

MATERIAL AND METHODS

The descriptive analysis was carried out as part of a report commissioned by the German Society of Internal Medicine and is based on data from the Federal Statistical Office and Eurostat as well as the ACSC catalogue developed for Germany.

RESULTS

The top 10 reasons for inpatient treatment in IM include 7 ACSCs. These diagnoses account for almost one quarter of cases and treatment days and mostly relate to cardiology. The international comparison including numerous other indications shows that other countries have both significantly fewer cases and shorter lengths of stay for most indications.

CONCLUSION

The results show that IM in Germany has considerable potential for optimization of inpatient care. In light of the regional variation in service providers and utilization as well as the potential for avoiding inpatient treatment, the current reform plans represent an opportunity for the reorientation of IM. Not least because of its high relevance, also in terms of numbers, it is therefore right and important that it is given such strong consideration within the reform plans.