[Evaluation and performance-based budgeting of the Halle University Outpatient Clinics]

The Medical School of Halle has fundamentally restructured the university hospital's outpatient clinics. This required a detailed analysis of costs, income, and organization, as well as a prospective survey. In a representative month, more than 15,000 consultations were documented. Of all visits, 9% were part of clinical trials, and 19% part of the teaching and training of students and young doctors. 52% of all appointments were follow-up consultations. Operative and non-operative specialties as well as general and specialist consultations displayed considerable differences. Clinics with a high rate of follow-up consultations attended to fewer trial participants than others. In comparison to a district covered by statutory health insurance physicians the proportion of oncological diagnoses in the university hospital outpatient clinics was markedly higher. Costs for the different specialties' outpatient clinics varied significantly; a positive correlation was noted between the percentage of oncological diagnoses and secondary costs. The outpatient clinics' commitment to the outpatient care of cancer patients exceeds by far the scientific focus of the Medical School of Halle and contributes greatly to the provision of regional health care services. Within the scope of the project, the annual faculty allowances to the outpatient clinics were reduced by 25%. Since 2003, 60% of the remaining total allowances have been made available to the departments as an output-related grant. It was crucial to the acceptance of this budgeting that the expenses saved were dedicated to the support of young scientists, that the budgeting was comprehensible and that scientific achievements and in future also high quality teaching will continue to help regain some of the money "lost".