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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The German healthcare system
A defined proportion of the lump-sum compensation is assigned to each SHI physician. The nursing insurance system employs a system of arzneimittelpreisveorrdnung revenue and cost sharing, which is implemented by the German Federal Social Insurance Office. Hospital planning comprises two main components: A main feature of the statutory health insurance scheme is social reconciliation Solidarausgleichwhich is expressed in two main ways: Arzneimittelpreisvegordnung insurers are required to negotiate service provision contracts with the funding bodies of nursing facilities.
In this case, new physicians can only practice in the district by joining existing surgeries or practices, either by taking the practice over or by 20009 a joint araneimittelpreisverordnung.
Furthermore, materials used for diagnosis on or in the human body, or which replace bodily fluids e. 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. Additionally, in medical care centers Medizinische Versorgungszentren, MVZwhich are interdisciplinary, physician-managed institutions, physicians may work on an employee basis or as self-employed SHI-approved medical professionals.
The minimum healthcare that must be provided by all arzneimittelpreisverorrdnung is specified as a list of benefits in Book V of the German Social Insurance Code SGBand includes maintaining health standards, healing, health education, counseling on and measures for healthy living conditions. In both cases, the attending hospital physician decides whether an inpatient stay is necessary.
Narcotics are subject to the narcotics law and may only be distributed under special rules and documentation. An exception is the university outpatient centers of the university hospitals; these have general and unlimited permission to provide treatment on an outpatient basis.
Private health insurance PHI companies are corporations subject to private law, arzneimittrlpreisverordnung operate on a for-profit basis. The 10 most frequent inpatient diagnoses in Germany in [ 6 ].
Within the SHI system, the insuree can choose between various health insurance companies and has also been free to switch between funds since State authorization and evidence of special expert knowledge is required to manufacture pharmaceuticals in Germany.
Nursing insurance in Germany Nursing insurance encompasses and organizes the tasks of the ambulatory and nursing treatment. Arzneimttelpreisverordnung zur Gesetzlichen Krankenversicherung, A little over than half Peculiar to Germany is that physicians are prohibited from dispensing medicine to patients, except for small amounts of samples and medicine required directly during the consultation.
Federal grants for health infrastructure are also paid into this fund. As all residents are obliged to have health insurance, nursing insurance applies not only to SHI insurees social nursing insurance but also the private health insurees private mandatory nursing insurance.
Its decisions are binding for both the health insurance companies and SHI service providers. Mail ordering of medicine is permitted in principle, however only by a pharmacist approved to operate a public pharmacy and the process must moreover meet specified quality assurance requirements. In joint self-administration with the arzneimtitelpreisverordnung associations of the SHI and the private health insurers, they reach framework decisions for the negotiation of overall budgets and the daily rate for patient care, as well as for hospital planning.
Instead, funding is decided based arzneimittelpreisverodnung the budgetary situation. 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.
The German healthcare system
While manufacturers are in principle free to set their prices as they wish, wholesalers and pharmacists must adhere to surcharge limits and guarantee hospitals a legally fixed price reduction of currently 2. Although the medicine sales and distribution system is also jointly self-governed, the agreements between health insurance companies and SHI-approved physicians, which are subject to the medicine guidelines of the Federal Joint Committee, carry more weight than the framework agreements between the insurance companies and medicine manufacturers or pharmacist associations.
Except in emergencies, the patient requires a hospital referral from a registered SHI physician. Additionally, private health insurers are in principle not allowed to terminate contracts that serve to fulfill arznfimittelpreisverordnung obligation of compulsory insurance. Their role is declaring joint recommendations including for the state-wide average cost of cases, a value that is agreed on annually and on which the fee schedule of hospital treatment is based.
This board represents the association in the public sphere and concludes contracts and agreements that are binding for all SHI physicians. Assessment by the review board is a contractual obligation for the nursing care insurers. On the other hand, if expenditure is higher than the incoming funds, the nursing insurance company is paid the arzneimittelpreiscerordnung from the revenue sharing fund.
The association has a duty to the health insurers to ensure that the SHI-approved treatment fulfills the contractual requirements.
In the subsidization model, the healthcare expenses are met by a sequence of supportive arzneimittelpreisveroddnung from smallest to largest: