Article ; Online: Zwischen Ökonomisierung und Versorgungssicherheit: Die stationäre Pädiatrie im ländlichen Raum.
Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany))
2021 Volume 84, Issue 3, Page(s) 219–226
Abstract: On the basis of the current hospital financing system, the economically viable operation of small departments is hardly possible. Ensuring the availability of medical specialists "round the clock" in these departments leads to high fixed costs. ... ...
| Title translation | Pediatrics in Rural Regions Caught between Thrift and Ensuring Adequate Healthcare Provision. |
|---|---|
| Abstract | On the basis of the current hospital financing system, the economically viable operation of small departments is hardly possible. Ensuring the availability of medical specialists "round the clock" in these departments leads to high fixed costs. Remuneration through the diagnosis-related system is currently calculated using the cost accounting of specialized service providers and large clinics. In contrast to the smaller departments providing basic care, the maintenance of basic services represents only a smaller percentage of costs for large facilities.There are legal and economic limits to the political influence on the hospital financing system. If adequate provision of healthcare is at risk, takeover of a private hospital by the local authority can be considered under certain conditions. In addition to quality indicators, the municipal subsidiarity principle must be complied with in a takeover of a hospital. Even under municipal sponsorship, work must be done to ensure economic efficiency. It is questionable whether a municipal authority can achieve greater efficiency than a large private hospital group. A possible consequence would be a reallocation of costs to the society. While maintaining current hospital funding, small hospitals in rural areas are at a disadvantage. Personnel shortages exacerbate the situation. With the mechanisms of the free market, it cannot be assumed that private hospital operators have an increased interest in the operation of appropriate clinics. A (re) municipalization with the same financing model will probably not make it more economical to operate, but appears to be an option for political reasons. Changes to the hospital financing system are required if further disadvantages to rural areas or reduction in healthcare provision are to be counteracted. |
| MeSH term(s) | Child ; Delivery of Health Care ; Germany ; Hospitals ; Humans ; Pediatrics ; Rural Population |
| Language | German |
| Publishing date | 2021-01-25 |
| Publishing country | Germany |
| Document type | Journal Article |
| ZDB-ID | 1101426-x |
| ISSN | 1439-4421 ; 0941-3790 ; 0949-7013 |
| ISSN (online) | 1439-4421 |
| ISSN | 0941-3790 ; 0949-7013 |
| DOI | 10.1055/a-1327-2614 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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