In , people were employed in pharmaceutical-producing companies . in the Pharmaceutical Price Ordinance ( Arzneimittelpreisverordnung). Seit sinkt die Zahl der Apotheken in Deutschland. Filialstruktur 05 . in der Arzneimittelpreisverordnung leicht angepasst. Index ( = ). wird in Deutschland durch die Arzneimittelpreisverordnung reguliert. and debt crisis, in particular in the second half of and
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In this system, the health insurance companies are obliged to transfer all premiums, excluding supplementary charges, to the federal bank. Thus, the emphasis is on keeping premiums stable and any increase in costs in one area results in a reduction of services elsewhere.
The nursing facility has to meet certain requirements to enter into a service provision contract. Rehabilitation centers and similar, specialized inpatient facilities are not considered hospitals. This inpatient treatment is remunerated from the overall compensation package for outpatient medical treatment, while the hospital expenses are charged to the patient or health insurance company in a separate billing procedure.
If arzneimitteplreisverordnung applicant is accepted, the insuree chooses between various services to create a specially tailored benefits package.
The German healthcare system
If the condition of a nursing recipient worsens, the review board can assign a higher care classification in a follow-up assessment. The SHI system is not obliged to cover drugs that relieve minor ailments e. Supply of medicine in Germany Under German law, medicine is defined as materials and preparations of materials intended to cure, alleviate, prevent or diagnose diseases, ailments, physical injury or other physical complaints when applied to or in the human or animal body.
Excluding hospital pharmacies, the manufacture, distribution and sale is undertaken by private companies pharmaceutical manufacturers, wholesalers, pharmacies.
In larger clinic networks, a board of directors generally manages the enterprise as a whole. Hospitals not in the hospital plan have to individually negotiate a service provision contract with the state associations of statutory health insurers in order to be authorized to treat SHI insurees SHI-approved hospitals. Once the service provision contract has been concluded, the insurers remunerate facilities directly. The dispensing of medicine to private patients and SHI insurees is essentially identical, except that private patients are reimbursed for the expense of the medicine rather than receiving the medicine directly.
For billing of private insurees, the applicable SHI fee schedule is taken as a starting point, and this amount can then be multiplied by a factor of up to 3. Verband der privaten Krankenversicherung e.
Assessment of the nursing level required is based primarily on the time family members need to carry out nursing tasks as opposed to the time required by a professional caregiver. Narcotics are subject to the narcotics law and may only be distributed under special rules and documentation. For example, the Federal Joint Committee G-BAon which physicians, dentists, hospitals, health insurers and patients are represented, has significant influence on which services are provided by the statutory health insurers and under which conditions.
These organizations all report to the Federal Ministry arzneimittelpreisverordnung Health, which drafts laws, regulations and administrative provisions, and is responsible for supervising subordinate federal agencies and appointing an expert commission to evaluate the development of public health.
Hospitals do not have a guaranteed right to large investment funding. The associations of SHI physicians 17 in total assume state duties as statutory arzneimittelpreiisverordnung, but at the same time also represent the interests of the SHI physicians. Within the SHI system, the insuree can choose between various health insurance companies and has also been free to switch between funds since Basic principles of social rights are used as the framework for ensuring social security in cases of illness, and must be followed by both the health arzneimittelpreisverorvnung companies and health service providers.
Number of hospitals and hospital bed [ 6 ].
Each arzneimittelpreisveroednung has physician, nursing and business administration teams, which are headed by a medical director, director of nursing, business director, respectively, who together comprise the hospital management. The contracts negotiated by the arzneimittelpreiaverordnung are binding for all SHI physicians. Number of statutory and private health insurance funds and insurees in Germany [ 1 ]. As all residents are obliged to have health insurance, nursing insurance applies not only to SHI insurees social nursing insurance but also the arzneimittellpreisverordnung health insurees private mandatory nursing insurance.
A voluntary member of the SHI scheme can only switch to the PHI system if their earnings have been above the compulsory insurance threshold for three consecutive calendar years. Only specially authorized hospital physicians are permitted to carry out such ambulatory treatment and the authorization is granted by the approval committee of the applicable association of SHI physicians for a limited, renewable term.
Only employees whose regular income is above the insurance threshold, civil servants, clergy, private school teachers, pensioners and the self-employed can choose the private health insurance system over the SHI scheme.
In return, after a multistep auditing process, the association remunerates the physician as a proportion of the lump-sum compensation paid by the health insurer.
At state level, this includes the state committee of physicians and health insurers the committee seats are occupied in equal measure by physicians and health insurers and decides whether a planning district is over- or under-suppliedthe approvals committee again, occupied in equal measure by physicians and health insurers and decides on applications for SHI-approval statusthe appointments committee and justice of peace officials.
In paying this amount, the service guarantee contract Sicherstellungsauftrag can hereby also be understood to have passed from the health insurers to the association of SHI physicians. Under certain conditions, hospitals can also treat patients on an outpatient basis. The person requiring nursing care submits an application for services to the nursing care insurer, which in turn instructs the review board to assess the type and extent of nursing care required.
These self-administration committees report to the state. The statutory health funds are not permitted to operate on a for-profit basis and excess contributions must be reimbursed to insurees generally in the form of premium reductions.
Additionally, unlike the SHI, private insurance funds do not enter into service provision contracts with physicians or hospitals with a few exceptions. As domestic environments, aged homes are not considered to be inpatient nursing facilities.
The German healthcare system
For instance, the nursing facilities ambulatory, partial inpatient, or full inpatient must be managed by a qualified nursing arzneimittelpreisverotdnung, guarantee performance-oriented and cost-efficient nursing care, have a proven in-house quality management system and meet specified staffing prerequisites. All approved medicines, as well as all companies and institutions that manufacture, assess, store, package or distribute drugs are subject to state monitoring.
In contrast, prescription drugs may only be sold in pharmacies. Compulsory health insurance was introduced for all residents in the Federal Republic of Germany on 1 st January The compensation is initially paid as a preliminary installment the physician receives the remaining proportion once all SHI-services in the individual health planning district have been settled. Private health insurance PHI companies are corporations subject to private law, which operate on a for-profit basis.
By thus relieving the burden on the state, they are in turn granted arzneimittelprwisverordnung say in health policy, and also represent the interests of their members and implement government regulation.
The hospital system is funded by two main sources: Nursing insurance encompasses and organizes the tasks of the ambulatory and nursing treatment. SHI physicians are subject to the laws governing the profession, the regulations of the federal and state associations of SHI physicians, the Treatment Obligations Ordinance, and are obliged to meet certain regulations regarding the distance between surgery and home residence, maintain regular consultation hours, participate in after-hours emergency rostering, document the work, report to the health insurers and ensure that the treatment provided is sufficient, appropriate and cost-effective and does not exceed the limits of the necessary.
The aim of this article was to give an overview about the German healthcare system and gain an understanding of its complexity and principles of organization. Over-the-counter medicines can be sold in grocery and drug stores, as well as in pharmacies.