[Impact of the public health reform law on non-university hospitals]

The 'Gesundheitsstrukturgesetz 1993' (GSG 1993) and the following law has resp. will considerably change the hospital scene. Thus the intended cost reduction in the hospital sector ought to be reached by the following measures: abolition of covering cost prices a more sufficient connection of in- and outdoor-patient treatments fixed budgets for 1993/1994 and resp. 1995 adoption of a differentiated system of fees a growing quota of the head physicians' charges for the sick-insurances In this context the abolition of covering cost prices is a minor problem. A more significant subject in consideration of the increasing requirements of hospital management is the organizational realization of the following aspects: rising forms of operating on outdoor-patients, pre- and post-indoor treatments, the period of fixed budgets in 1993/1994, resp. to 1995, as well as the calculation of the various fees. In addition to that the reduced revenues from the charges of head physicians pose a problem for the hospitals. The adoption of the new forms of treatment causes serious changes in both the functional and the proceeding organization of hospitals. The period of fixed budgets is of disadvantage in particular for those hospitals which did not manage to agree upon 'Fallpauschalen' and 'Sonderentgelte' until 1992 under the law of 1986 (Bundespflegesatzverordnung 1986). These prices or fees are not subject of the fixed budgets. Thus only hospitals having agreed upon these prices have the chance to raise their budget in case of an increased number of patients.(ABSTRACT TRUNCATED AT 250 WORDS)