Clinics - outpatient and inpatient care
Ingrid Müller is a chemist and medical journalist. She was editor-in-chief of for twelve years.Since March 2014 she has been working as a freelance journalist and author for, among others, Focus Gesundheit, the health portal ellviva.de, the publishing house living crossmedia and the health channel of rtv.de.
More about the experts All content is checked by medical journalists.Health care for patients in Germany is divided into three main areas: primary care (outpatient treatment by resident doctors), acute care (inpatient care in hospitals) and rehabilitation.
Outpatient care
Normally, general practitioners and specialists care for the patients in their practices on an outpatient basis. In some cases, however, hospitals that meet certain standards are also allowed to offer outpatient services.
In 2012, with the so-called GKV supply structure law, a sector-connecting supply area was introduced - outpatient specialist medical care. This is intended to be able to treat diseases that are difficult to treat and which require special qualifications of the treating physicians, special equipment or the cooperation of different disciplines, under one roof. This applies above all to the treatment of oncological and rheumatological diseases, severe forms of certain other diseases with particular disease courses or of rare diseases. Examples of such clinical pictures are cancer, HIV / AIDS or the lung disease cystic fibrosis. Chemotherapy for cancer can, for example, be carried out on an outpatient basis in a clinic, but also in a specialized practice. The same applies, for example, to dialysis for chronic kidney failure. Patients who are treated by a specialist on an outpatient basis come to the clinic and leave it on the same day.
Certain examinations and interventions can also be carried out on an outpatient basis in clinics, for example a cardiac catheter or cataract surgery. Outpatient therapy requires that the hospital operator has a permit from the responsible state authority.
Hospitals that are equipped accordingly are also entitled to provide outpatient services within the framework of integrated care. Here, patients are quality assured and cared for in interdisciplinary networked structures. Doctors, specialists from various disciplines, hospitals, prevention and rehabilitation clinics and other service providers cooperate and exchange knowledge and information.
Some clinics are also allowed to provide outpatient medical treatment as part of structured treatment programs for chronically ill people (health programs, disease management programs = DMPs). Such DMPs exist, for example, for diabetes, heart failure and cancer. In structurally weak, rural regions with a lack of resident doctors, hospitals can also support outpatient care.
All hospitals, contract doctors and medical care centers approved for outpatient treatment may bill for services. The selected clinics with their outpatient care offer are in principle available to all insured persons. For patients, outpatient care in the hospital means that there is no need to go back and forth between hospital stays that may be necessary and regular visits to the resident specialist, and treatment is coordinated from a single source.
Inpatient care
Some illnesses are so severe or protracted that they require increased medical observation over several days, nursing care or extensive treatment. These services can only be provided by institutions with appropriate specialists and the right medical apparatus and devices. Then an inpatient stay in a hospital is necessary. In the German health system, clinics are supposed to ensure high quality inpatient care across the board. In addition to general hospitals, prevention and rehabilitation facilities also offer inpatient accommodation with board and lodging.
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