[New responsibilities via the health care structural law concerning inpatient treatment]

The new Health Care Structural Law (GSG) brings about changes in e.g. medical care in hospitals, the consequences of which are of utmost significance. New forms of payment challenge hospitals to take into account in the hospital management the various forms of payment, to define new programmes of hospital performance and the realise competitive aspects while maintaining the quality of medical care. For the first time ever the new system of nursing fees focuses on the performance of the hospital instead of on its costs. The GSG induces a need to act in various areas of medical care in hospitals: The nursing staff regulation and the psychiatry staff ordinance require a procedure that leads to feasible results in contract negotiations, planning decisions and budget negotiations. In the model project in accordance with section 275a SGB V the necessity of the stay in hospital will be examined to verify that ambulant medical care takes precedence over medical care in hospital. The implementation of section 301 SGB V "Hospitals" is to guarantee a correct accounting with hospitals and is intended to enable the statutory health insurance institutions to perform their task as established by law to examine the necessity and duration of patient's stay in hospital. The evaluation and implementation of these tasks require solutions that do not focus on the individual case but lead to a systematic approach. Future examination procedures have to take the local conditions into account. The contents of the examinations must be standardised to facilitate a comparison on a regional and national level.