PMID- 12902012
OWN - NLM
STAT- MEDLINE
DCOM- 20040218
LR  - 20190906
IS  - 0736-4679 (Print)
IS  - 0736-4679 (Linking)
VI  - 25
IP  - 2
DP  - 2003 Aug
TI  - International report: current state and development of health insurance and 
      emergency medicine in Germany. The influence of health insurance laws on the 
      practice of emergency medicine in a European country.
PG  - 203-10
AB  - Germany has a comprehensive health insurance system, with only 0.183% of the 
      population being uninsured. Access to office-based medicine and to hospitals is 
      easy and convenient. Due to enormous financial pressures, Germany is currently 
      decreasing the number of beds in hospitals, introducing the Diagnosis Related 
      Groups (DRG), and restricting accessibility to specialists. In contrast to 
      Anglo-American countries, Germany follows the concept of bringing the physician 
      to the patient in the prehospital setting, with Emergency Medical Services (EMS) 
      physicians responding to all Advanced Life Support (ALS) calls. Despite a mature 
      EMS system with sophisticated medical equipment and technology, both in the 
      prehospital and hospital setting, logistical issues such as a single emergency 
      telephone number or multidisciplinary Emergency Departments have yet to be 
      established. Within the hospital, this "Franco-German model" considers Emergency 
      Medicine a practice model that does not merit specialty status. Spending 
      restrictions in the health care system, with less access to hospital beds and 
      office-based physicians, will increase the demand for hospital-based emergency 
      care when patients experience problems accessing the medical system. Currently, 
      the German hospital system is unprepared to care for greater numbers of emergency 
      patients. This may call for changes in the German health care system as well as 
      the medical education system, with the introduction of hospital-based Emergency 
      Medicine as its own specialty, similar to Anglo-American countries.
FAU - Platz, Elke
AU  - Platz E
AD  - Department of Internal Medicine, Kantonsspital Luzern, Luzern, Switzerland.
FAU - Bey, Tareg
AU  - Bey T
FAU - Walter, Frank G
AU  - Walter FG
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Emerg Med
JT  - The Journal of emergency medicine
JID - 8412174
SB  - IM
MH  - *Emergency Medicine/economics
MH  - Forecasting
MH  - Germany
MH  - Health Care Costs
MH  - Health Facility Closure
MH  - Hospital Administration
MH  - *Insurance, Health/economics/legislation & jurisprudence
MH  - Personnel Downsizing
EDAT- 2003/08/07 05:00
MHDA- 2004/02/19 05:00
CRDT- 2003/08/07 05:00
PHST- 2003/08/07 05:00 [pubmed]
PHST- 2004/02/19 05:00 [medline]
PHST- 2003/08/07 05:00 [entrez]
AID - S0736467903001732 [pii]
AID - 10.1016/s0736-4679(03)00173-2 [doi]
PST - ppublish
SO  - J Emerg Med. 2003 Aug;25(2):203-10. doi: 10.1016/s0736-4679(03)00173-2.