Why are there so many hospital beds in Germany?

IF 1.6 Q3 HEALTH POLICY & SERVICES
Matthias Brunn, Torsten Kratz, Michael Padget, Marie-Caroline Clément, Marc Smyrl
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引用次数: 2

Abstract

The place of hospitals in health systems is undergoing rapid change worldwide due to the high cost of hospital care and the changing health needs of the population. The Covid-19 pandemic has recently drawn public attention towards hospital capacity and has added new urgency to discussions on the future role of hospitals. In this context, recent experience in Germany provides valuable information for health systems seeking to manage hospital capacity. Despite reform efforts to reduce hospital capacity, Germany has the highest rates of intensive care beds among high-income countries and the highest overall hospital capacity in Europe. The capacity of the German hospital system can be explained in large part by the high number of elderly in-patients. This, in turn, is driven by (1) a fragmented ambulatory care system; (2) physicians admitting and maintaining elderly patients in hospital at a high rate; (3) a hospital market adding incentives to admit patients; and (4) a political commitment to egalitarian access and universal care. Additionally, recent policies to reduce hospital capacity have had limited impact because hospitals have not responded to financial incentives in the expected manner. Countries looking to learn from Germany's hospital capacity must therefore consider systemic features, political commitments, and unintended policy consequences.

为什么德国有这么多医院床位?
由于医院护理费用高昂和人口不断变化的卫生需求,医院在世界各地卫生系统中的地位正在发生迅速变化。Covid-19大流行最近引起了公众对医院能力的关注,并为讨论医院未来的作用增加了新的紧迫性。在这方面,德国最近的经验为寻求管理医院容量的卫生系统提供了宝贵的信息。尽管进行了减少医院容量的改革努力,但德国的重症监护病床率在高收入国家中是最高的,在欧洲的总体医院容量也是最高的。德国医院系统的容量在很大程度上可以用大量的老年住院病人来解释。这反过来又受到以下因素的驱动:(1)分散的门诊护理系统;(2)老年患者住院率高的医师;(3)建立医院市场,鼓励病人入院;(4)对平等准入和普遍医疗的政治承诺。此外,最近减少医院容量的政策影响有限,因为医院没有以预期的方式对财政激励措施作出反应。因此,希望向德国医院能力学习的国家必须考虑到系统特征、政治承诺和意外的政策后果。
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
Health Services Management Research
Health Services Management Research HEALTH POLICY & SERVICES-
CiteScore
4.00
自引率
4.80%
发文量
33
期刊介绍: Health Services Management Research (HSMR) is an authoritative international peer-reviewed journal which publishes theoretically and empirically rigorous research on questions of enduring interest to health-care organizations and systems throughout the world. Examining the real issues confronting health services management, it provides an independent view and cutting edge evidence-based research to guide policy-making and management decision-making. HSMR aims to be a forum serving an international community of academics and researchers on the one hand and healthcare managers, executives, policymakers and clinicians and all health professionals on the other. HSMR wants to make a substantial contribution to both research and managerial practice, with particular emphasis placed on publishing studies which offer actionable findings and on promoting knowledge mobilisation toward theoretical advances.
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