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Risikoselektion als Folge von Einkaufsmodellen im deutschen Gesundheitswesen: Instrumente, Indikatoren, Nachweis und Möglichkeiten zur Verhinderung der Risikoselektion

Risikoselektion als Folge von Einkaufsmodellen im deutschen Gesundheitswesen: Instrumente, Indikatoren, Nachweis und Möglichkeiten zur Verhinderung der Risikoselektion

          
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About the Book

Inhaltsangabe: Zusammenfassung: In Kapitel 2 wird zunächst eine Übersicht über das deutsche Gesundheitswesen gegeben, zu dessen wichtigsten Charakteristika das Solidaritätsprinzip, die prinzipielle Krankenversicherungspflicht sowie paritätische Finanzierung der Krankenversicherung, die freie Arztwahl und die Selbstverwaltung in vielen Bereichen zählen. Zu den Selbstverwaltungspartnern gehören die rund 350 gesetzlichen Krankenversicherungen, in denen knapp 90% der Bevölkerung versichert sind, die Kassenärztlichen Vereinigungen und die Krankenhausgesellschaften. Die Kassenärztlichen Vereinigungen und ihre Spitzenorganisation, die Kassenärztliche Bundesvereinigung, stellen die ambulante ärztliche Versorgung sicher, wofür sie eine befreiende Zahlung von den gesetzlichen Krankenversicherungen erhalten. In den Krankenhäusern erfolgt die stationäre Versorgung der Patienten, eine ambulante Versorgung ist, abgesehen von Notfällen, im Prinzip nicht vorgesehen. Die Vergütung der stationären Leistungen erfolgt derzeit überwiegend mittels tagesgleichen Pflegesätzen, daneben kommen Fallpauschalen und Sonderentgelte in ausgewählten Beeichen zur Anwendung. Diese Vergütung wird schrittweise ab 2003 auf diagnoseorientierte Fallpauschalen, die Diagnosis Related Groups, umgestellt. Für die gesetzliche Krankenkassen besteht Kontrahierungszwang bezüglich der Versicherten, aber auch - von wenige Ausnahmen abgesehen - mit den zugelassenen Leistungsanbietern. Die Finanzierung des deutschen Gesundheitswesens basiert überwiegend auf den gesetzlichen Krankenkassen und den übrigen Sozialversicherungszweigen. Daneben wird ein nicht unerheblicher Anteil auch von den privaten und öffentlichen Haushalten sowie den privaten Krankenversicherungen getragen. Im Ausgabenbereich stellt die stationäre Versorgung den größten Kostenblock vor der ambulanten ärztlichen Leistungserbringung und der Arzneimittelversorgung dar. Der Risikostrukturausgleich zwischen den gesetzlichen Krankenversicherungen soll die


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Product Details
  • ISBN-13: 9783838675749
  • Publisher: Diplom.de
  • Binding: Paperback
  • Language: German
  • Returnable: N
  • Spine Width: 10 mm
  • Weight: 240 gr
  • ISBN-10: 3838675746
  • Publisher Date: 05 Jan 2004
  • Height: 210 mm
  • No of Pages: 180
  • Series Title: German
  • Sub Title: Instrumente, Indikatoren, Nachweis und Möglichkeiten zur Verhinderung der Risikoselektion
  • Width: 148 mm


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Risikoselektion als Folge von Einkaufsmodellen im deutschen Gesundheitswesen: Instrumente, Indikatoren, Nachweis und Möglichkeiten zur Verhinderung der Risikoselektion
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Risikoselektion als Folge von Einkaufsmodellen im deutschen Gesundheitswesen: Instrumente, Indikatoren, Nachweis und Möglichkeiten zur Verhinderung der Risikoselektion
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Risikoselektion als Folge von Einkaufsmodellen im deutschen Gesundheitswesen: Instrumente, Indikatoren, Nachweis und Möglichkeiten zur Verhinderung der Risikoselektion

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