Information about the hospital system and about getting medical treatment in Germany.

Friday 29 December 2006

What types of hospitals are there in Germany?

In order to decide which clinic you want to trust, you should be aware of the different types of hospitals that can be found in Germany, it is important to know the structural background:

Most of the acute care hospitals are "public institutions", that means they are run by government authorities - though at different levels: An individual town, bigger or smaller, can be the owner/sponsor of a local hospital or two, or the county. The federal states run only very few of the hospitals - but the really big and qualified ones: The universities, with their medical faculties are generally state responsibilty. Then there is a big number of non-profit organisations, like Red Cross, churches of the major confessions with their different entities, religious orders like the "Order of St. John". Currently, the smallest number of hospitals is under private , for-profit, ownership. A number of "hospital chains" like "Rhoen-Kliniken", "Helios-Kliniken" or "Asklepios-Kliniken" is very active on the hospital market, buying hospitals that are unprofitable for the government sponsors or taking charge via management contracts.
These differences by sponsorship do not necessarily coincide with different levels of medical expertise. The medical and care responsibilty of any individual hospital is usually defined by the federal state. A "hospital plan" fixes the number and medical mission of the clinical departments of each hospital. In this system, a primary care hospital will have local responsibility (usually 2 - 5 departments), secondary level hospitals will have central regional responsibilty (6 - 15 or more departments) and maximum care responsibility (with a full spectrum of medical disciplines). The hospitals of the universities are also usually on this tertiary level.
In general, of course, the chairman of a department at a higher level of medical responsibilty has a more profitable, i.e. more attractive and more competitive position. Thus the qualification and expertise that can be expected at this level will be better. But there is no rule at all stopping a smaller hospital from hiring a highly qualified specialist and making his department a center of medical excellence in a certain field. Actually this a strategy favoured by many hospital managers in order to attract additional patients and improve the economic situation of the hospital.
On the other hand, the medical professor and chairman of a big university department , while undoubtedly being highly qualified, has so many additional duties in the university, from administrative work to teaching students, that he is frequently forced to leave most of the medical treatment activities to his "Oberärzte", senior consultants within his clinic. So the"big name" alone will not guarantee the best-possible treatment - especially in surgical disciplines, where daily practice in the operating theatre is perhaps of paramount importance for the best outcomes - more than scientific reputation based on the number of published scientific papers.

All this goes to say, that is is not easy to find the best clinic, the best physician, for any given medical problem. Insider knowledge is essential. Which is the business of patient referral companies like German-Hospital-Service Ltd.

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