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 insuree chooses the service provider and meets the incurred costs, which are later reimbursed by the insurance company based on the individual contract, either in full or in part. The person requiring nursing care submits an application for services to the nursing care insurer, which in turn instructs the review board to assess the type and extent of nursing care required.

Furthermore, materials used for diagnosis on or in the human body, or which replace bodily fluids e. However, this right only extends to medicines that arzneimittelpreisverordnyng, firstly, only available on prescription and, secondly, not expressly excluded in SHI service catalogue.

Ambulatory medical treatment in Germany Almost all outpatient medical treatment in Germany is carried out by registered physicians. Under certain conditions, hospitals can also treat patients on an outpatient basis.

The German healthcare system

Compulsory health insurance was introduced for all residents in the Federal Republic arzneimittelpreisverprdnung Germany on 1 st January The physician provides treatment, decides whether follow-up visits are necessary, refers patients to other specialist physicians where necessary, initiates hospitalization, prescribes drugs and decides whether home care is required.

Received Oct 19; Accepted Nov Private households pay deductibles and healthcare expenses such as over-the-counter medicines and services not covered by health insurance. Supply of medicine in Germany Under German law, medicine is arznwimittelpreisverordnung as materials and preparations of materials intended to cure, alleviate, prevent or diagnose diseases, ailments, physical injury or other physical complaints when applied to or in the human or animal body. Afzneimittelpreisverordnung dispensing of medicine to private patients and SHI insurees is essentially identical, except that private patients are reimbursed for the expense of the medicine rather than receiving the medicine directly.

Like physicians, pharmacists are obliged to join a state association. Both the state and federal associations are financed by member contributions, which are deducted by the associations for each SHI arzneimittelpteisverordnung from the lump sum compensation paid by the health insurers [ 127910 ]. Author information Article notes Copyright and License information Disclaimer. Nursing insurers are required to negotiate service provision contracts with the funding bodies of nursing arzeimittelpreisverordnung.

Please review our privacy policy. All approved medicines, as well as all companies and institutions that manufacture, assess, store, package or distribute drugs are subject to state monitoring.


The German healthcare system

Whether the applicant is approved is decided jointly by representatives of the association of SHI physicians and the statutory health insurance companies.

The statutory health funds are not permitted to operate on a for-profit basis and excess contributions must be reimbursed to insurees generally in the form of premium reductions.

Assessment of the nursing level required is based primarily on the time family members need to carry out nursing tasks as opposed to the time required by a professional caregiver. Nursing insurance encompasses and organizes the tasks of the ambulatory and nursing treatment. Specifically, the state must ensure sufficient, needs-based ambulatory and inpatient medical treatment, in qualitative and quantitative terms, as well as guarantee the provision of medicine.

Municipalities, as relatively autonomous regional authorities with a guaranteed right to local self-government, enforce the legislation governing healthcare professions, the distribution of foodstuffs and medical products, contagious disease prevention and control and health education and counseling, with the public health offices implementing the various associated measures [ 157910 ] Fig.

Regardless of whether a nursing allowance or non-cash services are provided, persons requiring care are entitled to the provision of nursing and technical aids e.

Nursing care insurance is not designed to comprehensively cover all necessary nursing care needs, but simply ensures basic nursing and home care. Additionally, unlike the SHI, private insurance funds do not enter into service provision contracts with physicians or hospitals with a few exceptions.

Private health insurance PHI companies are corporations subject to private law, which operate on a for-profit basis. The federal association also has a representative assembly and a full-time board. If the existing provisions do not meet the requirements, additional hospitals are included in the needs assessment.

In joint self-administration with the state 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 arzneimittelpdeisverordnung hospital planning. SHI expenditure is almost completely covered by premiums and to a small extent, also by other funding such as federal grantswhich are calculated according to earning power, rather than individual health risk profile, as a percentage currently Das Informationssystem der Gesundheitsberichterstattung des Bundes.

Except in emergencies, the patient requires a hospital referral from a registered SHI physician. The level of these reimbursements depends on the individual insurance contract. The main task service guarantee contract is ensuring insurees receive sufficient, uniform nursing care that meets the recognized standards of medical nursing care.

Representatives of the health insurance companies and service providers debate and decide key questions in service provision and remuneration in joint self-administration. These include the Robert Koch Institute disease control and prevention, particularly extremely dangerous or contagious diseases; federal health reportingthe Paul Ehrlich Institute arnzeimittelpreisverordnung drug safety; testing, approval and monitoring of vaccinations, sera and blood productsthe German Institute of Medical Documentation and Information development of medical classifications and medical databasesthe German Federal Arzneimittelpreisverordnng for Health Education development of health education and prevention strategiesthe German Federal Institute for Drugs and Medical Devices drug assessment and azrneimittelpreisverordnung, monitoring of legal narcotics trade and the German Federal Social Insurance Office.


Other relevant factors include the reason for referral, age, sex, weight at time of intake for infantsnumber of hours of artificial respiration, duration of hospitalization and reason for discharge.

The hospital system is funded by two main sources: A little over than half A voluntary member of the SHI scheme can only switch to the PHI system if their earnings have been above the compulsory insurance threshold for three consecutive calendar years. Outpatient medical treatment can be divided into treatment by GPs non-specialist internists, pediatricians and specialist medical treatment. Additionally, in medical care centers Medizinische Versorgungszentren, MVZwhich are interdisciplinary, physician-managed institutions, physicians may work on an arzneimittelpreisvfrordnung basis or as self-employed SHI-approved medical professionals.

Assessment by the review board is a contractual obligation for the nursing care insurers. Additionally, the medical associations enforce compliance with professional duties and form commissions that address various 2090, including a mediation commission, expert commissions for medical malpractice and review boards to evaluate research proposals.

In both cases, the attending hospital physician decides arzneimiytelpreisverordnung an inpatient stay is necessary. The states are obliged to assess the need for services within their district in a process known as hospital planning. Once the service provision contract has been concluded, the insurers remunerate facilities directly. The hospitals are represented at state level by associations of the funding bodies of approved hospitals. While hospital physicians usually carry out the hospital treatment, general practitioners, if SHI-approved arzneimitteppreisverordnung with special authorization from the association of Arzneimittelpreksverordnung physicians, can also treat patients on an inpatient basis—a provision that is limited to hospitals or hospital capacity also authorized for this purpose.

To improve the control of medicine sales and distribution, set prices were defined for some SHI-covered medicines, which are remunerated in full by the health insurance companies.