[Current health economic and policy issues in intensive care and emergency medicine].

IF 1.5 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-09-22 DOI:10.1007/s00063-025-01334-0

Michael Buerke, Engin Tükenmez

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Abstract

In 2025, intensive care and emergency medicine in Germany face profound structural and political transformation. The new Hospital Care Improvement Act (KHVVG) introduces a three-pillar financing model consisting of standby budgets, nursing reimbursement, and residual DRGs, aiming to reduce economic incentives and strengthen quality, safety, and specialization. At the same time, workforce shortages in medicine and nursing, as well as the integration of new roles such as Advanced Practice Nurses and Physician Assistants, pose major challenges. Structural reforms, regionalization, and the establishment of specialized centers are designed to ensure efficient resource allocation. Digitalization, telemedicine, and artificial intelligence offer opportunities for process optimization, cost management, and improved care quality, but require standardized frameworks and effective change management. In addition, sustainability initiatives, outpatient shifts, and quality-oriented payment models are gaining relevance. Overall, these developments mark a paradigm shift intended to secure high-quality, safe, and sustainable care for critically ill and emergency patients.

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[当前重症监护和急诊医学的卫生经济和政策问题]。

2025年，德国的重症监护和急诊医学将面临深刻的结构和政治转型。新的《医院护理改善法案》（KHVVG）引入了由备用预算、护理报销和剩余DRGs组成的三支柱融资模式，旨在减少经济激励，加强质量、安全和专业化。与此同时，医学和护理领域的劳动力短缺，以及高级执业护士和医师助理等新角色的整合，构成了重大挑战。结构性改革、区域化和专业中心的建立是为了确保资源的有效配置。数字化、远程医疗和人工智能为流程优化、成本管理和提高护理质量提供了机会，但需要标准化框架和有效的变更管理。此外，可持续性举措、门诊轮班和以质量为导向的支付模式正在获得相关性。总的来说，这些发展标志着一种模式的转变，旨在确保为危重病人和急诊病人提供高质量、安全和可持续的护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medizinische Klinik-Intensivmedizin Und Notfallmedizin MEDICINE, GENERAL & INTERNAL-

CiteScore

2.60

自引率

9.10%

发文量

审稿时长

6-12 weeks

期刊介绍： Medizinische Klinik – Intensivmedizin und Notfallmedizin is an internationally respected interdisciplinary journal. It is intended for physicians, nurses, respiratory and physical therapists active in intensive care and accident/emergency units, but also for internists, anesthesiologists, surgeons, neurologists, and pediatricians with special interest in intensive care medicine. Comprehensive reviews describe the most recent advances in the field of internal medicine with special focus on intensive care problems. Freely submitted original articles present important studies in this discipline and promote scientific exchange, while articles in the category Photo essay feature interesting cases and aim at optimizing diagnostic and therapeutic strategies. In the rubric journal club well-respected experts comment on outstanding international publications. Review articles under the rubric "Continuing Medical Education" present verified results of scientific research and their integration into daily practice. The rubrics "Nursing practice" and "Physical therapy" round out the information.