|Implemented in this survey?|
In November 2004 the Federal Office for Quality Assurance (BQS) issued its Quality Report 2003, a report on external quality assurance that published full and specific outcome data for all German hospitals authorized to take part in public health care. This report, the first of its kind in any country, presents the assessment of 33 defined surgical and diagnostic measures against quality indicators for medical and nursing procedures.
Purpose of this quality management initiative is to increase transparancy and quality of processes in hospitals in the German health care system.
Quality assessment was already required under the 1989 Health Care Reform Act. But reports by experts, such as the 2000 Report of the Advisory Council for Concerted Action in Health Care, still described severe shortcomings in quality assurance. The Reform Act of 2000, the Case Fees Amendment Act of 2002 and the SHI Modernization Act of 2004 introduced further measures. In 2004 responsibility for quality assurance moved to the Federal Joint Committee, the highest decision-making board in the German self-governing health care system. This move underscores the growing importance of quality assurance in hospitals in recent years.
Quality assurance for hospitals in Germany now rests on several pillars:
Financial: The appraisal of hospital procedures on the basis of scientific evidence is the prerequisite for reimbursement by the sickness funds.
Non-financial: From 2005 on, hospitals may also use the data generated through the BQS to externally demonstrate their capacity in their structured quality reports. Thus the information can be used as a marketing tool in the competition between hospitals.
Hospitals (administration, physicians, nurses), Patients, Sickness Funds
Quality assurance in hospitals has been on the agenda for quite a while in Germany. Since 2001 the BQS leads and coordinates the external comparative quality assurance in German
hospitals based on Paragraph 137 Social Code Book V. This was done under the governance of the Federal Board of Trustees for Quality Assurance (Bundeskuratorium
With the Statutory Health Insurance Modernization Act 2004 responsibility for the external quality assurance moved to the Federal Joint Committee (Gemeinsamer Bundesausschuß) the highest decision making board in the German self-governing health care system.This move underscores the importance quality issues and the quality assurance in hospitals gained in recent years. In addition to the Institute for Quality and Efficiency in Health Care (IQWiG) the BQS is another pillar of quality management under the responsibility of the Federal Joint Committee.
Together with this external quality assurance for hospitals compulsory quality management for ambulatory care was installed. This is part of an overall strategy to foster quality assurance in the German health care system as a whole. This was part of a strategy the Federal government had on its agenda since the beginning of this legislative periode in 2002.
Overall strategy to increase quality in the German health care system- hospitals and ambulatory care
|Implemented in this survey?|
The approach of the idea is described as:
amended: External quality assurance in hospitals already established since 2001
External quality management in hospitals was already established before the Health Insurance Modernization Act 2004. The move of responsibilities to the Federal Joint Committee was crucial to strengthen the role of external quality management in the German health care system.
|MoH||sehr unterstützend||stark dagegen|
|Hospitals||sehr unterstützend||stark dagegen|
|Sickness Funds||sehr unterstützend||stark dagegen|
|Patients representatives||sehr unterstützend||stark dagegen|
|CDU/CSU||sehr unterstützend||stark dagegen|
|Sickness Funds||sehr groß||kein|
|Patients representatives||sehr groß||kein|
Sebastian Hesse, Susanne Weinbrenner, Sophia Schlette