Thomas Kopetsch () (Kassenärztliche Bundesvereinigung, Berlin)
Abstract
The strict separation between the ambulatory and hospital sectors of the German health system has been the subject of massive criticism on the grounds that it is (one of the factors) responsible for inefficiencies. This article describes an empirical study of the relationship between service events in the ambulatory and hospital sectors of the German health system. The aim of the study is to facilitate an assessment of the consequences of abolishing Germany's almost unique dual specialist structure, a move widely considered politically desirable. The results of the empirical analyses of the relationship between the service events in the two sectors are ambiguous. When the analysis is based on the density of office-based doctors, services in some medical specialities can be interpreted as complementing each other. When the number of cases per office-based doctor is taken as the basis, however, the relationship can be seen as substitutive, since the more patients a doctor treats, the fewer the number of hospital cases recorded in the region. Finally, when the ambulatory cases are considered as a whole, the relationship between the sectors is again seen to be complementary. It is impossible to determine unambiguously whether the fundamental relationship between the sectors is predominantly complementary or substitutive. There is thus a need for further research.
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Article provided by Justus-Liebig University Giessen, Department of Statistics and Economics in its journal Journal of Economics and Statistics.
Volume (Year): 227 (2007) Issue (Month): 1 (February) Pages: 49-64 Download reference. The following formats are available: HTML
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