[Competition in the hospital sector at the time following the German Health Structure Act--what can the individual hospital do?].

In the medium and long term, a fundamental structural change of the hospital sector can be expected. The future framework--monistic financing, reform of hospital demand planning, service contracts, introduction of new compensation models--will have considerable effects on existing hospitals. Rescinding the factual governmental guarantees protecting the permanent existence of these facilities, self-responsibility for economic risks as well as intensified substitutional competition will increase the intensity of competition. Hospitals have to adapt to these externally given conditions by internal changes. Parts of this adjustment are reforms of inhouse organization and of the legal status of the institutions. Analyzing the casting structure requires the establishment of an information system as basis for planning and decision making. Besides, measures regarding the range of services offered, as well as the production process, become necessary.