Germany's new charging system has mixed results
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《英国医生杂志》
The number of patients in Germany seeking health care from their GPs or specialist practitioners was 15% lower in January 2004 than in the previous month. Health reforms, including charges to see a doctor, were introduced in Germany at the beginning of the year. However, in December 2003 practices were exceptionally busy as patients saw their doctors for treatment and prescriptions before the changes were introduced.
The decrease in visits in January was announced by Roland Stahl, speaker of the National Association of Statutory Health Insurance Physicians.
Despite the reforms about 8% more patients attended doctors?practices in January 2004 than in January 2003.
The German Society of General Practitioners has reported that patients with mild illnesses seemed to avoid practices. It is not yet clear whether the new reform will achieve its aim of lowering healthcare costs by deterring patients from unnecessary visits and using their GP as a guide through the health system.
Since January patients have had to pay a �10 (￡6.80; $12.70) fee every three months for each visit to their GP or to a specialist. The money is passed on to the health insurance companies. If a patient is referred to another doctor or a hospital no fee has to be paid. The new regulation, which also applies to emergency visits to hospitals and for visits to renew prescriptions, has upset and confused patients and doctors. The regional Associations of Statutory Health Insurance Physicians had to establish hotlines, which received about 2000 phone calls per day.
"The situation was not as chaotic as expected," said the president of the National Association of Statutory Health Insurance Physicians, Dr Manfred Richter-Reichhelm, Berlin. However, doctors and practice assistants had to spend extra time and effort to administer the collection of the fee and hand out receipts, without being financially rewarded for it. Dr Richter-Reichhelm fears that as a result time for treatment and for communicating with patients has had to be reduced. In some rural practices patients have had to wait several hours to be treated.
Furthermore, sales of drugs in pharmacies dropped considerably, partly because of an increase in sales of about 40% in December 2003 but also because patients have tried to avoid prescription drugs. Since January patients have had to pay more towards the cost of drugs, fewer drugs have been available on prescription, and drug firms have put up prices, especially for drugs bought over the counter.(Heidelberg Annette Tuffs)
The decrease in visits in January was announced by Roland Stahl, speaker of the National Association of Statutory Health Insurance Physicians.
Despite the reforms about 8% more patients attended doctors?practices in January 2004 than in January 2003.
The German Society of General Practitioners has reported that patients with mild illnesses seemed to avoid practices. It is not yet clear whether the new reform will achieve its aim of lowering healthcare costs by deterring patients from unnecessary visits and using their GP as a guide through the health system.
Since January patients have had to pay a �10 (￡6.80; $12.70) fee every three months for each visit to their GP or to a specialist. The money is passed on to the health insurance companies. If a patient is referred to another doctor or a hospital no fee has to be paid. The new regulation, which also applies to emergency visits to hospitals and for visits to renew prescriptions, has upset and confused patients and doctors. The regional Associations of Statutory Health Insurance Physicians had to establish hotlines, which received about 2000 phone calls per day.
"The situation was not as chaotic as expected," said the president of the National Association of Statutory Health Insurance Physicians, Dr Manfred Richter-Reichhelm, Berlin. However, doctors and practice assistants had to spend extra time and effort to administer the collection of the fee and hand out receipts, without being financially rewarded for it. Dr Richter-Reichhelm fears that as a result time for treatment and for communicating with patients has had to be reduced. In some rural practices patients have had to wait several hours to be treated.
Furthermore, sales of drugs in pharmacies dropped considerably, partly because of an increase in sales of about 40% in December 2003 but also because patients have tried to avoid prescription drugs. Since January patients have had to pay more towards the cost of drugs, fewer drugs have been available on prescription, and drug firms have put up prices, especially for drugs bought over the counter.(Heidelberg Annette Tuffs)