Structural comparison of management apsects of community healthcare centres in Europe with special focus on Germany.

Author:Renger, Fabian


The provision of high quality health care at an affordable cost is a major challenge for health care systems all over the world. In many countries, the bulk of annual spending growth is due to increases in the prices of health care goods and services, and the availability of ever more new, often high-cost medical products and treatments. As a result, health care providers are facing ever greater pressure to reduce operational costs without affecting the level and quality of their services (Kaplan & Haas, 2014). In this context, hospitals are of particular interest as they make up the largest cost component in the health care system. Typically, all these health care resources are scarce and so the challenge lies in synchronizing their availability with the needs for care. Taking a broader context, logistics is also concerned with patient flows. Planning, coordinating, and controlling the resources involved in material as well as in patient flows are the functions performed by operations management (OM). Hence, similarly to industrial settings, logistics and OM are also two intertwined areas in a hospital, together, they account for a sizeable portion of a hospital's budget. In the area of information technology, focus has been given to the development of modern hospital information systems (HIS) (Baerwolf, 2010). These systems are designed to deal with all aspects of information processing in a hospital. In particular, they enable the collection, storage, management, and retrieval of data related to the clinical, administrative, and financial aspects of providing services within the hospital.


In most countries in the European Union, governments are responsible for health policy and legislation (Commission, 2016). Overall the government's plays supervisory roles among the numerous actors involved in health care, with several functions being shared with or delegated.

General Task, Bodies and Aims

* Insurance provides free access to a package of services; services not included in this package may require

* Upfront payments by patients, or co-payments. Direct payments are also made when using benefits that are

* not covered by the package or that are delivered through physicians not employed by the respective social

* Health insurance fund. Exemptions from co-payment exist for specific categories of patients (chronically ill, below a certain income level, etc.).

Provincial authorities are specifically responsible for the implementation of hospital care, the maintenance of hospital infrastructure, health promotion and prevention services; social welfare benefits and services are the responsibility of local governments (districts, statutory cities and municipalities). Access to health services is not regulated, in that patients are not obliged to enroll with one specific physician and physicians do not play a gate-keeping role. Patients may thus also access outpatient departments of hospitals without referral. Outpatient care is provided through physicians (some self-employed), outpatient clinics, privately owned or belonging to the social health insurance funds, other specialists and outpatient departments of hospitals. Physicians usually have a contract with the social health insurance funds.

Healthcare in the European Union

Different countries in the European Union have different system of healthcare services, examples are as outlined in the following countries diversified by size of members within...

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