German Healthcare System

29 Nov 2010
Posted by arun

German Hospitals are famous for the high benchmarks they set in the field of medical care. The highlights of the German medical system are that, they have the most qualified physicians who are allowed to practise as specialists in their respective fields only after long and intensive training, nursing that is professional and devoted to the patients’ care and the most modern medical equipment available right there in the country where it is invented.

There are strict government guidelines in Germany which regulate the quality of medical care available and the services are routinely supervised. There are also government set standards on the pricing of the medical services making healthcare in Germany economically affordable too. There is no waiting list system for important operations and treatments.
A number of German hospitals have set up small scale companies inside the hospital itself. These are called private clinics and their sole purpose is to provide treatments to international patients at rates above that specified by the DRG. These private clinics differ from ordinary hospitals only in the fact that they provide high hotel standard accommodation and service while the treatment remains the same as any other standard German hospital. Many other standard hospitals are available in Germany whose treatment standards are just as good as the above mentioned hospitals if not better, who treat international patients also at DRG specified rates. In this way the cost of medical treatment in Germany can be reduced by almost 50% without in any way compromising on the treatment standards. It is a difficult task for an outsider to understand which hospitals provide treatments to international patients at DRG prices, since there are over 2000 hospitals offering acute care in Germany. We here at heart-consult are dedicated to helping you find the right hospital.
Medical treatment in Germany is economically very viable. There is no need to be in any waiting list in case of an emergency or for certain treatments like in countries like the UK and if your nation has social security health plan the costs of your treatment will be reimbursed. There are rulings by European courts and authorities that make this mandatory. Also the legal framework of hospital finance proceedings in Germany makes it highly profitable for the hospitals to service foreign patients. Hence you can be rest assured that the hospitals will make sure you are given the very best treatment. 
The German Hospital system is very vast and includes about 2000 acute care hospitals. They are grouped according to their sponsorship and service. There are hospitals sponsored by:
  • Local or State Governments - Local governments like that of towns and counties and state governed where the responsibility of the university rests in the federal states as a part of their responsibility for education. 55% of hospitals in Germany are government sponsored.
  • Hospitals sponsored by non-profit organisations like churches or the red cross etc. About 38% of German Hospitals are sponsored by non-profit organisations.
  • Private companies and hospital chains. 7% of hospitals are run by for profit companies.
According to the service provided German law classifies hospitals as follows.
1. Hospitals providing basic services or primary care hospitals. These have up to 200 beds and 2-3 medical disciplines.
2. Hospitals providing regular service or secondary care hospitals. They have around 300 beds and 4-5 disciplines.
3. Central service or tertiary level hospitals with about 500 beds. These are institutions specialising in more than 8 medical disciplines and are usually attached to a university as a teaching hospital.
4. Maximum care hospitals. These are the big multi speciality hospitals offering a wide range of medical services. They also carry out research and teaching along with treatment.
The head of the medical department is usually a superintendent or chairman who is employed by the hospital. The medical responsibility may also be carried by one or more practitioners or voucher physicians, who have their private clinics and treat patients at hospitals on a special contract basis.
The following are the costs involved in the German hospital system:
  • Hospital cost 
  • Physician cost
  • Extra charges for special lodging
  • Outpatient surgery
  • Other
There is a system of general price for hospital services in Germany, called DRG. This is inclusive of Medical care, food and lodging. The system aims at creating a uniform cost for medical treatment in Germany. Patients are allowed the option to avail additional treatments according to their wish. This may incur extra costs not included in the DRG. The most expensive being treatment by the hospital superintendent himself since he may charge his personal fees in the bill.
The German health insurance system covers the medical treatment costs including DRG costs for German citizens. Foreign nationals may be allowed the option to fund their medical expenditure from their respective foreign health insurance, but this should be subjected to prior approval, exceptions being in the case of accident or medical emergency. Patients who are not covered by general health insurance have to pay the costs for treatment.
German hospitals have a standard for lodging where a fixed cost is applied for double bedrooms for two patients. Lodging for a patient in a single room is possible with an additional charge. 
German hospitals offer outpatient surgery, that is they offer short term services like a surgery for instance. The patient who accepts the service arrives in the morning, gets prepared for surgery and is given a high priority among other patients and is operated first in special rooms. Following the  surgery, the patient is allowed to leave in a short span of time. Transfer of the outpatient to inpatient may occur if there are any complications in the surgical procedure. Foreign patients who are interested in the service are advised to arrange necessary accommodation in nearby hotels so that they may attend follow up tests and examinations.
Some hospitals offer excellent rehabilitation facilities after the treatment. Additional charges are levied for these. Other charges include telephone costs for the calls made by the patient during the stay, TV use and personal internet access facilities wherever provided.
The German Medical system has some established standards. Medical students are made to undergo rigorous training and strict evaluation processes to ensure quality of service. Students have to pass a basic scientific study before they are admitted to the clinical part of their course. Moreover they have to serve as an assistant or resident physician for a period of 5-7 years before they can qualify as a senior resident in a particular specialization and they are required to complete a catalogue of important procedures and surgeries within this time period.
Nurses are trained thoroughly for three years in a government prescribed curriculum. The colleges which offer nurse training courses are under strict state supervision and offer theoretical as well as practical training. Exams are also conducted under state supervision. Nurses are given the chance to specialize in various fields like surgery assistant, anaesthetics nurse, in-charge of ward etc on completion of a stipulated duration of service.
German hospitals are subject to a various quality controls and these are enforced with the highest levels of efficiency. Data is collected on the various procedures conducted in the hospital and is routinely and systematically reviewed by various government regulatory bodies. Strict quality checks are in place thanks to the apropos legislation by the government. Hospitals are constantly under quality surveillance programs and hence are always expected to deliver top notch quality. German hospitals these days are competing with one another to obtain quality certifications like DIN-ISO, EFQM, KTQ, Procum Cert or the Joint commission quality management scheme etc.