Zero Disease. Angelo Barbato
Чтение книги онлайн.
Читать онлайн книгу Zero Disease - Angelo Barbato страница 10
Название: Zero Disease
Автор: Angelo Barbato
Издательство: Tektime S.r.l.s.
Жанр: Медицина
isbn: 9788873040453
isbn:
The sickness insurance funds programming negotiate and acquire the services for their patients. The German systemâs financing mechanism is therefore dualistic: the Land defines and funds investment, while the mutual aid society negotiates and finances the current healthcare costs by dealing with both hospitals and affiliated physicians.
For hospital functions, the regional association for mutual aid signs a contract with each hospital, while for outpatient functions it negotiate a global agreement with the regional association of doctors.
Mutual aid is called to protect the interests of its members, trying to influence the volume and the producerâs case mix, as well as to respect the insurance spending thresholds, implicitly set out by the Government through the maximum rate of contributions payable by the subscribers.
With an excess of hospital beds (8.3 per 1,000 inhabitants compared to the OECD average of 4.8 and 2.6 in Sweden and 3.4 in Italy), the rate of hospitalization (25 admissions per 1,000 inhabitants compared to the OECD average of 15.5, 16.2 in Sweden and 12.8 in Italy) and the average duration of hospital stay (9.2 days compared to the OECD average of 7.4, 6.0 in Sweden and 7.7 in Italy); in terms of financial resources, Germany has the most important hospital network in Western Europe19 .
The acute care hospitals were 2,017 in the year 2012, with 501,475 beds: 601 public, 719 private non-profit and 697 private for-profit, with a split percentage split of respectively 48%, 34% and 18% of beds. In addition to acute care hospitals, 1212 structures specializing in rehabilitation exist, holding 168,968 bed places. Among these institutions, only 19% are public, 26% are private non-profit and 55% private for-profit. 18% of hospital beds are in public facilities while the other structures respectively host 16% and 66%. Next to a progressive reduction of beds for acute illnesses, the number of beds in rehabilitation and psychiatric facilities has more than doubled.
German citizens have full freedom of choice of care and professional place, with no distinction between general practitioners and medical specialists.
This model - which does not include the role a of gatekeeper doctor, or a doctor who acts as a filter for access to specialist care - is typical of the Bismarck model, but is rapidly changing as a result of a reform approved in 2004.
Such reform, since 2004, has introduced several innovations in order to strengthen local services (and to reduce the pressure on hospitals): among them is the need to encourage the enrollment of the clients to a general practitioner who in addition to playing the role of filter for access or "gatekeeper", also is responsible for the coordination of care. There is no obligation, but who does not comply is subject to reduced co-payments and waiting lists. The number of patients assisted by the "gatekeeper" or General Practitioner (GP) is growing (in 2012 to 4.6 million).
Another innovation is the overcoming of the model of care based a single physician, with the development of medical centers of interdisciplinary care (increased from 70 to 1,814 from 2004 to 2012).
Конец ознакомительного фрагмента.
Текст предоставлен ООО «ЛитРес».
Прочитайте эту книгу целиком, купив полную легальную версию на ЛитРес.
Безопасно оплатить книгу можно банковской картой Visa, MasterCard, Maestro, со счета мобильного телефона, с платежного терминала, в салоне МТС или Связной, через PayPal, WebMoney, Яндекс.Деньги, QIWI Кошелек, бонусными картами или другим удобным Вам способом.