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 contrast, prescription drugs may only be sold in pharmacies. The health fund is administrated by the Federal Social Insurance Office, which determines how much of the fund will be allocated to each insurance company based on specific criteria, which together comprise the morbidity-based risk adjustment scheme.
Arzneimittel-Festbeträge – GKV-Spitzenverband
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.
The health insurers compensate the SHI-approved treatment of its members as lump sums per insuree, negotiated with and paid to the association of SHI physicians. An additional responsibility of the association is representing the economic and professional interests of the SHI physicians.
While, with the exception of military hospitals, the federal government does not directly fund healthcare facilities, it does maintain a number of healthcare institutes and federal agencies, each with its own areas of responsibility. Depending on the funding body, the hospitals are public local district, state, federal government or statutory corporation hospitalsnon-profit the funding bodies have religious, humanitarian or social goals or private the funding body has commercial goals, e.
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 arzneimittelpreisvfrordnung to or in the human or animal body. Consequently, on a legal and decision-making level, bodies such as the health insurance companies and associations of statutory health insurance SHI physicians function as indirect, outsourced public administration authorities with some measure of self-governance, which take the form of statutory corporations.
0209, private health insurers are in principle not allowed to terminate contracts that serve to fulfill the obligation of compulsory insurance. Hospitals do not have a guaranteed right to large investment funding.
This coverage is not permitted to cost more than the highest SHI premium and must be guaranteed by the private health insurance companies without individual risk assessment contractual obligation.
Private health insurers are also obliged to offer specified minimum services, the cost of which may not exceed the corresponding highest Arsneimittelpreisverordnung rates. Potential inpatients are entitled to preliminary information in easily understood language, which must explain the services, the available additional services which have to be remunerated separately on a user-pays basisarzneimittelpreisveerordnung and the results of quality monitoring.
This is expressed legally as the service guarantee contract Sicherstellungsauftrag. Even though some states delegate the service guarantee contract to municipalities, the responsibility for adequate hospital care remains that of the state in the final instance.
Published online Dec Peculiar to Germany is that physicians arzneimittelpreisvedordnung prohibited from dispensing medicine to patients, except for small amounts of samples and medicine required directly during the consultation. Together the two types of insurance form the nursing insurance system, whose common institutions are the nursing insurance companies. The premiums collected by the public and private health and nursing insurance companies, on the other hand, are employed for direct healthcare services, such as the remuneration of service providers e.
Remuneration of the SHI physicians takes the form of a fee distribution system. Medical association members elect representative assembly delegates, who, in turn, qrzneimittelpreisverordnung a board of directors. Hospital physicians are only allowed to treat patients on an outpatient basis in exceptional cases. For billing arzneimittelpreisverordnungg private insurees, the applicable SHI fee schedule is taken as a starting point, and this amount can then be multiplied by a factor of xrzneimittelpreisverordnung to 3.
An exception is the university outpatient centers of the university hospitals; these have general and unlimited permission to provide treatment on an outpatient basis. These self-administration committees report to the state. Compulsory health insurance was introduced for all residents in the Federal Republic of Germany on 1 st January Healthcare services are provided by both public e.
In contrast, a resident can quit the contract at anytime and with immediate effect, if, for arzneimittelpreisvdrordnung, significant service deficits exist here too, the nursing facility must pay for the cost of relocation [ 13 ].
Private health insurance PHI companies are corporations subject to private law, which operate on a for-profit basis.
Private households pay deductibles and healthcare expenses such as over-the-counter medicines and services not covered by health insurance. For instance, the hospitals have to a be under the continual medical management of physicians, b have sufficient diagnostic and therapeutic capabilities to meet the terms of the hospital provision contract, c work according to scientifically recognized methods, d which can be applied by around-the-clock medical, nursing, support and technical staff, e to diagnose, cure, arrest and alleviate illness or provide obstetrics, primarily through physician and nursing care, f and which can provide patients with room and board.
As part of ensuring that medicine supply to humans and animals proceeds according to applicable rules and regulations, the state must provide for safety in the handling and distribution of medicine, in particular for the quality, effectiveness and harmlessness of the medicine. A prerequisite is that adequate treatment is only possible if the hospital physician in question is authorized to provide outpatient treatment.
Their role is declaring joint recommendations including for the state-wide average cost of cases, a value wrzneimittelpreisverordnung is agreed on annually and on which the fee schedule of hospital treatment is based. The following paper provides an overview of the structural organization, individual components and funding of the German healthcare system, which, in its current form, is extremely complex and arznrimittelpreisverordnung even experts find difficult to grasp.
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.
The German healthcare system
Number of statutory and private health insurance funds and insurees in Germany [ 1 ]. 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 insurance companies and health service providers. The 17 state pharmacy associations are statutory corporations that represent professional policy interests, support the state authorities in the monitoring of medicine safety and quality and together comprise the federal pharmacy association.
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. Statutory Health insurance in Germany Compulsory health insurance was introduced for all residents in the Federal Republic of Germany on 1 st January These organizations all report to the Federal Ministry of 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.