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Application of the Multiregional Health Account for Germany - A financial equalization scheme to cope with lagging investments in German hospitals

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  • Schwärzler, Marion Cornelia
  • Kronenberg, Tobias

Abstract

Lagging investments in German hospitals have become a serious challenge in recent decades. The responsibility for investment financing lies with the German federal states, the “Bundeslaender”, due to the dualistic financing framework applying for German hospitals. Yet, hospital investments experience a field of tension between the availability of financial resources and necessary investments. A possible solution could be a financial equalization scheme for the health economy incorporating an earmarked fund for hospital investments. The rationale for such a system is that health economies of federal states do not represent single closed systems, but depend on interregional trade flows to supply patient treatment. The respective calculations in this paper are based on our recently compiled Multiregional Health Account for Germany. The model represents a satellite account of the health economy based on national accounts. Consequently, we are able to calculate spillover effects from patient treatment in federal states by conducting input-output analysis. Based on the results, we derive a sketch of a financial equalization scheme in order to ensure needs-based hospital infrastructure in German federal states.

Suggested Citation

  • Schwärzler, Marion Cornelia & Kronenberg, Tobias, 2017. "Application of the Multiregional Health Account for Germany - A financial equalization scheme to cope with lagging investments in German hospitals," MPRA Paper 80720, University Library of Munich, Germany.
    • Handle: RePEc:pra:mprapa:80720
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    References listed on IDEAS

    as
    1. Schwärzler, Marion Cornelia & Kronenberg, Tobias, 2017. "Basic Results of the Multiregional Health Account for Germany - Validation of Direct Effects of the Health Economy," MPRA Paper 80717, University Library of Munich, Germany.
    2. Umed Temurshoev & Marcel P. Timmer, 2011. "Joint estimation of supply and use tables," Papers in Regional Science, Wiley Blackwell, vol. 90(4), pages 863-882, November.
    3. Schwärzler, Marion Cornelia & Kronenberg, Tobias, 2017. "Methodology of the Multiregional Health Account for Germany - An Iterative Algorithm-Based Multiregionalization Approach of Supply and Use Tables with Emphasis on Health," MPRA Paper 80712, University Library of Munich, Germany.
    4. Rürup, Bert & Albrecht, Martin & Igel, Christian & Häussler, Bertram, 2008. "Umstellung auf eine monistische Finanzierung von Krankenhäusern. Expertise im Auftrag des Bundesministeriums für Gesundheit," Publications of Darmstadt Technical University, Institute for Business Studies (BWL) 35311, Darmstadt Technical University, Department of Business Administration, Economics and Law, Institute for Business Studies (BWL).
    5. Ranscht, Anja, 2009. "Quantifizierung regionaler Wachstums- und Beschäftigungseffekte der Gesundheitswirtschaft : am Beispiel ausgewählter Metropolregionen," Publications of Darmstadt Technical University, Institute for Business Studies (BWL) 34095, Darmstadt Technical University, Department of Business Administration, Economics and Law, Institute for Business Studies (BWL).
    6. Schwärzler, Marion Cornelia & Kronenberg, Tobias, 2016. "Methodology of the National Health Account for Germany - Database, compilation and results," MPRA Paper 73561, University Library of Munich, Germany.
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    1. Schwärzler, Marion Cornelia & Kronenberg, Tobias, 2017. "Basic Results of the Multiregional Health Account for Germany - Validation of Direct Effects of the Health Economy," MPRA Paper 80717, University Library of Munich, Germany.
    2. Schwärzler, Marion Cornelia & Kronenberg, Tobias, 2017. "Methodology of the Multiregional Health Account for Germany - An Iterative Algorithm-Based Multiregionalization Approach of Supply and Use Tables with Emphasis on Health," MPRA Paper 80712, University Library of Munich, Germany.

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    More about this item

    Keywords

    Health economy; hospital investments; financial equalization scheme; input-output analysis; multiregional; federal states; Germany;
    All these keywords.

    JEL classification:

    • C67 - Mathematical and Quantitative Methods - - Mathematical Methods; Programming Models; Mathematical and Simulation Modeling - - - Input-Output Models
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • R15 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - General Regional Economics - - - Econometric and Input-Output Models; Other Methods

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